Primary responsibility is to review and follow up on paid insurance claims, including zero-pay claims, and payer recoupments to determine whether reimbursement is accurate according to contracted rates.
The role performs root-cause analysis, identifies underpayments and reimbursement opportunities, and reports findings to leadership. It also involves reviewing remittances, correspondence, payment posting, contractuals, and payer trends to ensure appropriate reimbursement and accurate account resolution.
Additional responsibilities include communicating with payers and other parties to resolve discrepancies, submitting appeals and adjustments, documenting follow-up activity in the AR system, supporting system testing and training, and meeting productivity goals.
Required
- High school diploma or GED
- 2–3 years of billing, insurance follow-up, or insurance payer experience
- Experience with account resolution involving third-party payers preferred
- Working knowledge of ICD-10, revenue codes, CPT-4, and HCPCS
- Moderate computer proficiency, including Microsoft Excel, Word, and Outlook
Knowledge and skills
- Ability to read and interpret contracts, claims, policies, and procedures
- Strong math skills for rate calculation
- Ability to analyze data and make sound financial decisions related to patient accounts
- Detailed knowledge of uniform bill guidelines
- Experience working with EOBs, contractual adjustments, and payer contracts
- Strong documentation, communication, and organizational skills
- Ability to meet productivity expectations and work collaboratively
Location
Louisville, Kentucky, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago