• Works daily electronic billing file and submits insurance claims to third-party payers
• Reviews, evaluates, and forwards manual patient account statements to payers that do not accept electronic claims or that require special handling
• Assists with receipt of and correspondence related EOBs, payer notices, and payer audits/record reviews
• Monitors bill holds, payer rejections and electronic payers' error reports and coordinates with other departments to resolve issues and facilitate timely claim submission
• Works with other departments to resolve questions related to medical codes, modifiers, and/or other elements present on the claim form
• Performs follow up to resolved aged claims, and documents all reasons for reimbursement delays as well as actions taken within the patient accounting system ensuring all is appropriately documented in system
• Regularly evaluates denials to determine if follow up action is necessary and initiates the appeals process
• Notes denials trends, and informs the lead biller and/or department manager of findings to mitigate future claims rejections
• Acquires and maintains a general understanding of regulations affecting billing practices and disseminates knowledge to departmental staff; reports any suspected compliance issues
• Reviews, investigates, and resolves credit balances
• Performs all other duties as assigned by departmental leaders

Associate's Degree Preferred.

2-Years of customer service and / or business office experience, ideally in medical setting preferred.