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Responsible for processing all third party claims for inpatient and outpatient primary and secondary claims for professional billing. Heavy collections and accounts follow-up on all outstanding balances.
PATIENT AGE GROUP SERVED
Direct patient care
DUTIES AND RESPONSIBILITIES
Expedites and maximizes payment of insurance medical claims by contacting third party payors and patients.
Review third party payors Aged Trial Balance Report to locate and resolve accounts. Collaborates with management in developing a plan to reduce aging of accounts over 90 days by providing verbal and written communication.
Investigate and appeal unpaid, or partially paid claims by insurance companies.
Resolve denials as they appear.
Review claims to verify payments are made according to fee schedule and contractual adjustments are taken appropriately.
Must meet established follow-up productivity goal of completing 200 claims per week.
Identify claims processing issues and notifying Manger to avoid further delay in claims processing.
Document clear, concise and complete follow up notes in system for each account worked.
Assure accounts are completed and worked at a high level of quality by visually proofreading and monitoring work output.
High School Diploma or GED; college degree preferred
Five years physician billing experience, preferably in a multi-specialty academic physician practice.
In depth knowledge of CPT-4 and ICD-9 coding; CPC preferred.
In depth knowledge of third party payor reimbursement policies and procedures.
Profiency in MS Office Suite.
CERTIFICATES, LICENSES AND REGISTRATIONS REQUIRED
SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
Strong customer service, phone and scheduling skills.
Knowledge of insurance requirements for physician visits and procedures.
Knowledge of requirements for non-invasive lab procedures.
Extended periods of walking and standing may be required.
Professional Office Environment