Handle all aspects of accounts receivable for professional claims, including denial management, analysis of denials, follow-up on unpaid claims, and identification of barriers to reimbursement.
Major responsibilities
- Follow up on outstanding accounts receivable by working and analyzing denials and unpaid claims with payers
- Use payer websites and phone calls to ensure timely and accurate claim processing and payment
- Work in the revenue cycle system to process claims, check eligibility, and make corrections
- Coordinate with practices and hospital departments to answer claim-related questions and process claims
- Research and respond to insurance company requests through follow-up and correspondence, including medical record requests, appeals, and claim resubmissions
- Complete payment tracking forms when funds have been sent to the hospital
- Complete refund forms for overpayments due to insurance companies or patients
- Keep management informed of reimbursement challenges and claim-related trends
- Perform other duties as assigned
Requirements & Qualifications
Education
- High school diploma or equivalent required
Experience
- 1 year of experience in physician billing, medical practice charge entry or coding, and/or hospital revenue cycle processes required
Knowledge and skills
- Proficiency in reading, writing, and speaking English
- Knowledge of medical billing, insurance reimbursement practices, and medical insurance requirements
- Strong 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 at 45 words per minute
Physical requirements
- Motor coordination and finger dexterity to operate a calculator, computer keyboard, and typewriter
- Light lifting and carrying
- Reaching for and handling lightweight files
Location
North Carolina, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
3 weeks ago