Resp & Qualifications PURPOSE: This position ensures that accounts are accurately invoiced, reconciled and outstanding payments are collected so that the core system is correct and the account is satisfied. Serves as first point of contact for internal and external customers regarding all billing and collection issues. The employee will assist in the clarification and development of process improvements and inquiries, assure payments related to patient services from all sources are recorded and reconciled timely in order to maximize revenues. ESSENTIAL FUNCTIONS: Researches and responds by telephone, or in writing to patient inquiries regarding billing issues and problems. Reviews billing forms for accuracy and completeness before sending to payors. Ensures all insurance, demographic, and eligibility information is obtained from patients and entered into the system in an accurate and timely manner. Assists with billing issues, including contacting insurance carriers to confirm patient eligibility and referral information. Confirms patient insurance verification and eligibility; obtains preauthorization of services and/or referrals; assesses patient financial requirements and advises patients and families on insurance benefits, copays and financial obligations. Adhere to HIPAA guidelines and other relevant state and federal regulations, and company policies regarding to compliance, integrity, patient privacy and ethical billing practices. Assists in the preparation of monthly billing and accounts receivable reports. QUALIFICATIONS: Education Level: High School Diploma or GED. Experience: Less than one year experience in a Billing, membership enrollment, member services, claims operations or Finance role. Knowledge, Skills and Abilities (KSAs) Proficient in Microsoft Office applications. Provide excellent customer service with a focus on department goals. Works well in environment with firm deadlines; results oriented. Salary Range: $31,824 - $58,344 Salary Range Disclaimer The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). Department Facets Billing & Collections Equal Employment Opportunity CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. PHYSICAL DEMANDS: The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. Sponsorship in US Must be eligible to work in the U.S. without Sponsorship.