• Daily processing of all billing consents for both admitted and discharged patients.
• Review of daily admission, discharge report and late charge report to ensure charges are billed correctly in STAR before weekly billing run is produced
• Follow-up with bed allocation team on outstanding forms related to billing and collection of payment
• Correct financial class inaccuracies following registration process
• Perform billing for WSIB, IFH , out of province, Ambulance charges, landed immigrant status, invalid health card and out of county residents and perform patient interviews related to the above.
• Adding patient transfer costs to patient bills and refund generation
• Sort and file correspondence, and perform miscellaneous clerical duties such as answering correspondence, returned mail and writing reports to assist in reconciliation of the receivable accounts.
• Perform address changes for guarantor accounts and returned mail
• Contact insurance companies to check on status of claims payments and write appeal letters for denial on claims.
• Follow up on all outstanding claims from aged trial balance
• Assist In follow-up call to account for payment collection purposes
• Answers questions and concerns presented by patients, physicians, insurance companies and other hospital staff.
• Performs research of accounts that may need additional charges or adjustments.
• Enters late charges into STAR in a timely manner
• Create timely claim submission files and submit to the MOHLTC according to Patient Accounts department schedule
• Apply OHIP clinic payments to accounts on a timely basis and balance to bank deposit
• Electronic Data Transfer analysis of accounts at time of application for any missing information. .
• Coordinates and contacts the physician or clinic to resolve the rejections and discrepancies
• Assist with error reports on a monthly basis
• Reconcile billing remittances against claims on a monthly basis
• Maintain regulations and standards affecting patient confidentiality.
• Research medical documentation when needed, to confirm the use of billing codes
• Correct OHIP rejections on a timely basis, resubmit electronic and manual submissions as required
• Examine, correct & edit missing reading & referring physicians by contacting depts., referencing SOB(schedule of benefits) & listing of physician billing errors
• Coordinate with and contacts the physician or clinic to resolve OHIP discrepancies
• Follow up on physician and management inquiries
• Other duties as assigned
• 2 years community college or Post secondary education in Accounting preferred
• Mandatory 3 years prior Healthcare receivable experience
• Knowledgeable on OHIP billing codes and diagnostic error codes
• Be proficient in meeting regular deadlines
• Proficiency in interpretation of MOH Schedule of Benefits codes and Preamble
• Excellent data entry, keyboard and excel skills required
• Demonstrated ability to organize and prioritize duties
• Excellent communication skills at all levels
• Proficient in MSWord, Excel, Outlook , Internet required
• Previous OHIP/Accounts Receivable experience required
• High degree of accuracy and attention to detail required
• Knowledge of Privacy Act required
• Good attendance record required
We want to tell you more about Grand River Hospital in this section. You'll find information about: Our governance and leadership; Contact information; How to do business with the hospital; Capital plans and construction; and Reports as well as accountability documents.
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