Responsibilities include following up on insurance claims, checking eligibility, handling medical denials and appeals, tracking multiple accounts and deadlines, identifying and correcting errors, documenting all calls accurately and in a timely manner, working correspondence, and interpreting payer guidelines.
Additional job duties include processing appeals, reviewing payer bulletins, retrieving medical records, following up on delinquent accounts, reconciling payer remittance, processing assigned bills, completing reports, monitoring aging accounts, handling correspondence, and supporting other departments as needed.
Requirements & Qualifications
Required Qualifications
- High school diploma or equivalent
- 2+ years of experience in a hospital, insurance, or office environment
- Prior experience involving public contact
- Knowledge of insurance requirements, regulations, and billing guidelines, including Medicare, Medicaid, HMO, PPO, and commercial policies
- Knowledge of ICD-10 and CPT coding systems
- Experience with claims follow-up, denial resolution, and appeals
- Strong analytical and critical thinking skills
- Excellent attention to detail
- Proficiency in Microsoft Office, especially Excel
- Ability to operate office equipment such as copiers, fax machines, and printers
- Ability to work independently with minimal supervision
- Strong communication skills
Preferred Qualifications
- Some college coursework
- Experience processing commercial and managed care claims
- Experience with automated systems
- Medical terminology knowledge
Location
Texas, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago