Essential Duties and Responsibilities:
Initiate outbound calls to patients to complete accident interviews via telephone.
Investigate and confirm any medical coverage related to auto, general liability, and/or worker compensation insurance available to the patient, updating the patient file in Pace and the hospital system.
Contact Auto/Work Comp insurance carriers and attorneys via telephone to identify available accident insurance coverage for the patient.
Verify patient’s eligibility for coverage and obtain billing contact information for the insurance adjuster and/or attorney.
Send hospital bill to no-fault, third party and workers’ compensation insurances via fax, mail and e-mail.
Follow up for with insurance carriers and attorneys for expedited resolution and payment on patient’s account.
Request documentation where applicable or payment and account status from insurance adjuster or attorney.
Identify any patient attorney representation and confirm patient representation with the attorney office, recording the attorney information in the patient file in the system.
Maintain proper account documentation in CHC’s Case Management System
Send correspondence to patient, insurance adjusters and attorneys.
Receiving inbound calls from patients, attorneys, insurance companies, etc. and being able to identify the callers need to help come to a resolution (Hunt Group).
Working claims 100% of the time.
File Hospital Liens (where applicable)
Assist in settlement negotiation between the hospital and patient’s attorney/insurance adjuster.