ESSENTIAL DUTIES AND RESPONSIBILITIES

1. Analyzes, researches and processes insurance claims through electronic claims management systems in a timely manner.
2. Ensures accurate and complete clean claim submission for both paper and electronic claims
3. Processes claim updates based on direction given by facility or coding liaisons
4. Evaluates electronic insurance rejections in order to re-transmit with corrected claim information
5. Investigates rebill requests submitted to the billing department and processes these requests when appropriate
6. Audits claims/accounts for charges, duplications, and overlapped accounts prior to billing, making any necessary adjustment
7. Reviews patient account information for accuracy in billing
8. Documents actions taken in collection system
9. Informs Billing Managers of any charging trends or edit trends and provide examples/education to other departments to reduce errors
10. Ability to perform all other duties as assigned or requested

QUALIFICATIONS

REQUIRED:

• Diploma or GED
• Minimum two (2) years’ work experience with insurance claims and handling; billing experience with UB04 and 1500 or state specified form.

• Knowledge of Word Processing software, Spreadsheet software and E-mail software

PREFERRED:

• Associate’s Degree (A.A.)