Understands medical policies and checks quarterly for updates.
Analyzes and researches unpaid insurance claims and requests or provides needed information from insurance providers in a timely manner.
Reviews all aspects of claims, including patient demographics, diagnosis codes, signed doctor prescription, proof of delivery, and insurance information in Medisoft to ensure claim validity.
Anticipates and performs required oral and written communications to payers to ensure proper documentation timelines for accounts receivable management.
Facilitates payer reimbursements with acceptable hands-on knowledge of claim processes, contracted rates, and collections statutes.
Analyzes and composes payer appeals on outstanding accounts receivable issues.
Produces detailed and concise final draft notes on all necessary claims.
Generates patient statements periodically.
Reviews and audits medical records prior to sending records to insurance.
Researches and verifies refund requests, posts take-backs, and applies adjustments to patient files.
- DME experience preferred: 1 year
- Accounts receivable experience preferred: 1 year
- Knowledge of medical policies, insurance claims, and payer communications
- Ability to review and audit medical records and claim documentation
- Familiarity with Medisoft and accounts receivable management processes
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Location
California, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 week ago