This position is responsible for the proper processing of paper and electronic claims, identifying, and correcting patient accounts with any insurance to ensure timely and accurate claims submission. This position must understand payor requirements and know the specific payor regulations.
· Resolving patient account work queues to ensure medical coverage is accurately added to all appropriate accounts. Verifies eligibility, plan, and payer information in order to properly submit the claims.
· Responsible for resolving claim edits, changes, and corrections to the patient's account. Ensures that the correct medical coverage is applied to the account for claims dates of service.
· Resolve stop bills due to coverage change, overlaping dates of service, perform combined account functions, and understanding payor specific requirements and state requirements.
· Responsible for the Undo billing function in the Epic system and NRP action with full understanding of activities.
· Responsible for Client/Corporate account workflow, which includes invoice billing and balance reconciliation per contract guidelines.
· Monitors assigned outstanding claims and proactively identifies, researches and proposes solutions to trends.
Requires a High School Diploma or equivalent