Responsibilities :

• Reporting of carrier performance according to contracted fee schedule
• Denial management
• Good oral and written communication skills
• Effective Problem-solving skills and make independent decisions
• Work effectively in a team environment
• Perform consistent, assertive, efficient and timely follow-up on accounts as determined by Management
• Able to understand and effectively interpret payer contracts, Remittance Advices (RA) and Explanation of Benefits (EOB) statements
• Medicare, Medicaid, and / or third party payer experience in dealing with healthcare insurance companies through phone follow-up and letter correspondence during the appeals or denial resolution process
• Corrects billing errors, edits, overlaps, etc., and submit clean claims
• Review payment variances and remittances for resolution in an efficient and timely manner for processing of patient and / or insurance refunds.
• Identify payer issues or trends and update Manager in a timely manner, providing concrete examples for Management to review.
• Other duties as assigned.

Requirements

• Minimum of a high school diploma, coding and billing courses helpful.
• Additional training in Athena and Trizetto a plus.
• Skill in computer applications

Full time - Monday to Friday

Last updated : 2024-05-14