Job Timings: 09:30 PM-05:30 AM
Responsibilities:
-Monitor Insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner- knowledge of questions to ask for proper processing.
-Working knowledge of CPT and ICD-9 and 10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits, and appeal process.
-Ability to stay aware of billing/submission delay issues (encounters not closed/items not being billed/more accurate coding to use for increased revenue)
-Ability to learn all office programs and foster relationships with vendors in order to provide timely daily/weekly/monthly/quarterly/yearly reports as requested/needed
-Work with providers to correct the diagnosis or procedure codes so that the claim can be processed.
-Respond to and process insurance claim disputes.
-Knowledge of electronic billing systems
-Coordinate insurance reimbursement of care providers
-Ability to work with staff to assist with referral/auths needed to ensure payment of procedures
-Researches and processes refund requests and overpayments.
-Generates and submits electronic claims and corrects any errors for complete and accurate transmission of data.
-Knowledge of medical terminology.
-Use of online reference data base services.
-Attention to detail, able to prioritize workload.
-Strong organizational and planning skills.
-Excellent written and verbal communications skills.
-Proficiency in MS Office and Patient Management software.
Preferred Experience:
-Revenue Cycle Management (RCM) Experience
-Certified Professional Coder (CPC)
