Job description

Job Description

Follow-Up Responsibilities:
Call insurance or use online payer portals for status on claims
Records appropriately detailed notes in Epic.
Takes appropriate action to resolve claims: write disputes, communicates with supervisor/lead.
Coordinates and provides feedback in payer meetings to discuss payer trends and issues.
Meets productivity and quality standards.
Demonstrates excellent customer service skills when interacting with patients to resolve claim issues (i.e. COB, Accident Details).
Demonstrates adequate, appropriate, and professional levels of communication with insurance company representatives, team members, supervisors, and managers.
Collaborates with Technical Denials Specialists to track, trend, and resolve claim issues.
Work insurance correspondence and inbound faxes timely and makes the necessary responses to the letters received.
Ensures timely turnaround of internal requests (EOB’s, medical records) through effective follow-up
Elevates serious barriers to claim resolution to the leadership team
Billing Responsibilities
Reviews bills and related information for accuracy and reasonableness of charges.
Work specific reports, as required for the payer(s).
Submits bills to payers electronically or by paper
Proficient in Government and Commercial payers regulations and reimbursement policies
Proficient in Government and Commercial payers contractual agreements and regulations to apply requirements for accurate billing and to make recommendations for system changes as needed
Computes required adjustments to bills, balances to support, and inputs debits/credits to billing system to appropriate codes to ensure accurate billing.
Follows up on insurance requests for medical records, COB, accident information, bundling issues, policy related restrictions, DRG downgrades, and using proper managed care tools for DRG calculations.
Qualifications

Education, Credentials, Licenses:
High school diploma

Specialized Knowledge:
Customer Service Skills
Excellent Communication Skills
Problem solving skills

Kind and Length of Experience:
One year of hospital Revenue Cycle or Patient Access

www.colinoncars.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, www.colinoncars.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, www.colinoncars.com is the ideal place to find your next job.