Work under the supervision of the Assistant Manager of Claims Management and Lead Insurance Claim Specialists. Analyze, process, submit, and follow up on inpatient and outpatient medical claims. Safeguard public relations and confidentiality of the organization and its records by consistent professional conduct.
Review all claims for complete and accurate information. Contact other departments, physician offices, and insurance companies to obtain necessary information for filing claims. Process, edit, and submit all claims for the organization.
Follow up on Commercial, Worker's Comp, VA, and Governmental claims via phone calls and online resources. Assist patients/guarantors with questions regarding unpaid claims and obtain information needed to submit claims for payment.
Process administrative appeals, reinstatements, and rejections of insurance claims. Maintain daily account follow up, meeting goals and notifying lead specialist if goals cannot be achieved.
Analyze daily correspondence like denials and underpayments to resolve issues appropriately. Adhere to HIPAA regulations by verifying authorization levels when sharing information.
Identify billing and coding issues and notify medical billers for correction. Verify patient eligibility, coverage, and status of claims through online systems.
Perform other duties as assigned.
Southern Ohio Medical Center is an equal opportunity employer and makes reasonable accommodations for qualified individuals with disabilities.
High School Diploma or equivalent required.
Preferred 3 to 6 months experience in medical billing.
No licensure required.
Location
Ohio, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
3 weeks ago