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^st level, and 2^nd 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.