Overview

Have a profound knowledge in the PCS process to identify system and/or coding errors and provide feedback to management in the following areas:

o Tab 7 reason

o Valid PCS attach but sending for new one

o Coders dumping claims in PCS schedule

o No attempts to identify for valid PCS

o DR name not being requested for the rolodex

o Other realizations to improve the PCS process

Responsibilities

• Review all the proper PCS workflow’s and ensure claims are being followed up on timely

• Attach and review any PCS forms received by fax or mail and bill out the claim to appropriate payer and schedule/event

• Mail and attach POM to Medicare claims within the 21 day billing mark. Ensure Medicare claims are being followed up on within 72 hours of each the 3 attempts for a DR name

• Responsible for auditing claims on hold for PCS, bill out claims that have a valid PCS form, and provide feedback to management for educational purposes

  o MI MCD MCOS

  o MI Medicaid

  o ISSUES PCS

• Maintain a thorough understanding of running reports through excel and power BI

  o Tab 7 missing

  o ZOI PCS picture not attached

  o PCS barcoded not attached

• Keep a communication channel between support and front end billing in order to support the need of area improvements and to promote insurance collections/compliance initiatives

• Establish expert knowledge for the required guidelines for PCS forms and be able to catch errors missed while billing

• Mail out batch PCS print jobs daily

• Tracking POM’s to ensure we have received all mail dates and pages back from post office.