Responsible for processing electronic and paper claims for all payers in a timely manner, reviewing claim error reports and audit trail errors, correcting and resubmitting billings, and performing follow-up throughout the claims adjudication cycle.
Key responsibilities include:
- Processing inpatient and outpatient claims through the electronic billing system
- Monitoring and resolving outstanding accounts receivable balances
- Correcting claims that error out before transmission to payers
- Working denials through the denial management system
- Reviewing audit trail reports, correcting rejected claims, and resubmitting them
- Responding to correspondence and updating patient account status notes
- Determining payment status using claim tools, phone, fax, and payer portals
- Preparing appeal documentation and supporting records for denied claims
- Maintaining AR, credit balance, Medicaid crossover, Medicare quarterly credit balance, and Medicare bad debt reports
- Supporting business office operations as needed
- Meeting productivity and quality goals
Requirements & Qualifications
Required qualifications:
- High school diploma or equivalent
- Good math skills
- Proficiency in Microsoft Word, Excel, and PowerPoint
- Strong customer service skills
- Strong verbal and non-verbal communication skills
- Valid driver’s license and satisfactory motor vehicle record
Preferred qualifications:
- 2–4 years of billing or insurance collections experience in healthcare
- Certified Patient Accounts Representative (CPAR) or Certified Revenue Cycle Representative (CRCR)
Location
Columbus, Georgia, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 week ago