Job Summary :
The primary responsibility in this role is to see insurance claims through to payment, working denials and following up with the payers as needed .
This is a specialized position and requires previous medical accounts receivable experience with working knowledge of CPT and ICD-10 codes
Supervisory Responsibilities :
None.
Duties / Responsibilities :
- Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
- Able to communicate and / or negotiate problematic accounts
- Gathers billing information by reviewing patient records; checking for completeness
- Communicating with payers to request payment and arrange payment plans
- Resolves disputed claims by gathering, verifying, and providing additional information
- Worklist of assigned claims and follow up with denials and appeals
- Increases revenue by collecting payments on outstanding accounts
- Manages and resolves aging accounts
- Conducts audits and reviews to ensure all documentation is accurate and precise
- Protects patient and family privacy rights and maintains confidentiality of patient records in accordance with policy and procedure and HIPAA requirements
- Writing appeal letters to dispute payor denials
- Submitting payor reconsiderations, 1
level, and 2
level appeals
Required Skills / Abilities :
- Familiarity with insurance payor websites
- Proficient use of CPT and ICD-10 codes
- Excellent computer skills including Excel, Word, and Internet use
- Detail oriented with above average organizational skills
- Plans and prioritizes to meet deadlines
- Excellent customer service skills; communicates clearly and effectively
- Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
- Work well within a team environment be able to work flexible hours as needed
Education :
High School Diploma or GED
Minimum Qualifications
- 2 years in a medical office or facility setting (required)
- 2 years in medical accounts receivable experience (required)
Physical Requirements :
Prolonged periods of sitting at a desk, working on a computer, and answering phones.
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