Responsible for all aspects of medical accounts receivable collections, claim status, and denial management.
Performs follow-up on outstanding medical A/R insurance claims with no payer response. Handles denials related to coverage questions, medical necessity, re-bundling, incorrect coding, credentialing, and other issues. Reviews electronic rejections and incoming correspondence from patients and insurance companies. Works with coders to correct or appeal coding and billing issues in a timely manner. Initiates refund and credit requests. Documents all steps taken to resolve balances pending by payer or patient. Escalates electronic claims submission problems and bulk rejections to management when needed. Mails manual claims to payers daily as needed. Works daily, weekly, and monthly aging reports as assigned.
Education and experience
- Strong working knowledge of insurance payers, including government, commercial, and managed care products.
- 2 years of experience preferred in a medical office setting.
Skills and qualifications
- Ability to build rapport with clinic managers and providers.
- Resourceful and persistent approach to timely claims follow-up.
- Comfortable navigating payer websites for claim status, appeals, and related tasks.
- Excellent verbal and written communication skills.
- Strong customer service skills with patients and clinic staff.
- Ability to multitask and manage time effectively.
- Strong teamwork and collaboration skills.
- Ability to communicate tactfully and courteously with patients and team members.
- Knowledge of CPT/HCPCS and ICD-10.
- Must protect PHI and follow HIPAA regulations.
- Must meet department quality and production standards.
- Must maintain attendance requirements and work full-time regular hours as scheduled.
Location
Texas, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 week ago