Handle all aspects of accounts receivable for professional claims, including denial management, analysis of denials, follow-up on unpaid claims, and identifying barriers to reimbursement.
Major responsibilities
- Follow up on outstanding A/R by working and analyzing denials, and following up on unpaid claims (primary, secondary, or tertiary) with payers
- Research issues that have contributed to unpaid claims
- Ensure accurate claim processing by following up with payers using payer websites and phone calls to ensure timely payment
- Work in the revenue cycle system to process claims, check eligibility, and make corrections to ensure accurate and timely claim resolution
- Coordinate and communicate with practices and hospital departments as needed to answer claim-related questions and process claims accordingly
- Research and make corrections to insurance company requests through timely follow-up and correspondence, including medical record requests, appeals, and claims resubmissions
- Complete payment tracking forms when monies have been sent to the hospital
- Complete refund forms for overpayments due to an insurance company or a patient
- Keep management informed of reimbursement challenges and claim-related trends
- Perform other duties as assigned
Requirements & Qualifications
Minimum qualifications
- High school diploma or equivalent required
- 1 year of experience in physician billing, medical practice charge entry or coding, and/or hospital revenue cycle processes and practices required
Knowledge and skills
- Knowledge of medical billing and insurance reimbursement practices and procedures
- Knowledge of medical insurance requirements
- Communication skills
- Excellent customer service and teamwork
- Computer skills including Microsoft Office suite
- Knowledge of medical terminology, ICD-9, and CPT-4 coding
- Ability to type accurately 45 words per minute
Location
North Carolina, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 month ago