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Role Description

Responsible for reviewing and submitting claims on a daily basis.

• Prepares and submits clean claims to various insurance companies either electronically or on paper.
• Contacts carriers by phone or website for claim status on outstanding insurance balances.
• Processes and works all insurance correspondence.
• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to other carriers.
• Obtains necessary documentation required to submit to insurance to expedite payments.
• Answers questions from patients, clerical staff, and insurance companies.
• Identifies and resolves patient billing complaints.
• Prepares appeal letters for all claims that are denied for payment.
• Documents all collection activities using guidelines in place.
• Identifies underpayments by checking payments received against our contracted fee schedule.
• Works and processes all insurance refund requests.
• Reports payer issues or delays to supervisor.
• Participates in educational activities.
• Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.
• Team player with ability to solve problems and recommend solutions.
• Must be able to manage assigned workload and prioritize accordingly.
• Maintains accurate and timely reconciliation of accounts receivable.
• Reviews claims stopped in the claim scrubber.
• Works claims rejected by the clearinghouse.

Qualifications

• High School Diploma or GED, and minimum one year experience in a medical billing/collections field.
• Ability to write and read.
• Ability to add, subtract, multiply, and divide on all units of measure, using whole numbers, common fractions, and decimals.
• Ability to read and interpret explanation of benefits remittances to determine and identify claim denial reasons and necessary course of action for resolutions.
• Ability to type 45 WPM, basic proficiency in Microsoft Outlook/Office, and experience using or ability to learn and comprehend computer programs.

Requirements

• None

Benefits

• None

Company Description

Position works in a climate-controlled office environment in a cubicle setting.