Processes and submits health insurance claims accurately and on time.
- Reviews claims for correct coding in accordance with current medical coding and billing guidelines, including CPT, ICD-10, and HCPCS.
- Collaborates with coding and clinical teams to resolve claim edits and denials.
- Maintains knowledge of Medicare, Medicaid, and commercial payer guidelines.
- Verifies patient eligibility and coverage before claim submission.
- Resolves edits in the EMR and clearinghouse to prevent denials.
- Follows up on denied or underpaid claims and submits appeals when appropriate.
- Reviews and resolves insurance and patient credit balances.
- Educates patients regarding billing questions, coverage, and payment responsibilities.
- Documents all account activity in the EMR.
Requirements & Qualifications
- At least 18 years of age.
- Legally authorized to work in the United States.
- Must pass a background check.
- Must pass a pre-employment drug screen and breath alcohol test, if applicable.
- Must complete an Employee Health meeting before starting.
- 2 years of prior experience in medical billing, accounts receivable, or a related field.
- Medical billing or coding certification such as CPC, CPB, RHIT, or CCS may substitute for experience.
- Preferred: prior authorization experience.
- Preferred: Epic or similar EMR experience.
- Preferred: knowledge of UB-04 and CMS-1500 claim forms.
Location
Colorado, US
Employment Type
Not specified
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago