Responsibilities:
- Provides Liaison between the providers of health care services, the patient, or other responsible persons, and revenue sources, to ensure the correctness of charges, a current record of all transactions, and account resolution.
- Maintains active communications with insurance carriers and third-party carriers until account is paid.
- Negotiates payment of current and past due accounts by direct telephone and written correspondence.
- Updates patient account information.
- Monitors and identifies payer denial trends and problem accounts; communicates patterns to supervisor.
- Runs a monthly aging report based on DOS and current A/R to identify accounts that require follow up.
- Manage all assigned worklist on a daily basis for assigned insurances.
- Utilize collection techniques to resolve accounts according to company's policies and procedures.
- Report any coding related denial to the Coding Specialist.
- Performs other duties including but limited to faxing information as required, generating retroactive authorization requests, and verifying medical eligibility.
- Conducts necessary research to ensure proper reimbursement of claims.
- Assist with special projects assigned by Billing Manager or Supervisor
Qualifications:
- High school diploma or GED equivalent.
- At least 3 years' experience in insurance collections.
- Knowledge of medical terminology utilized in medical collections and billing (CPT, ICD-10, HCPCS)
- Knowledge with letters of appeal. Intermediate experience with Microsoft Excel and Office products is required.
- Experience with HMO, PPO, and Medicare insurances.
- Must be able to read, interpret, and apply regulations, policies and procedures
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