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General Summary of Duties: This position is responsible for following up on claims from billing through final resolution. Other responsibilities include:

Essential Functions: Core duties include the following, but are not limited to:

  • Work denied and unpaid accounts receivable from insurance on a daily basis to secure payment.
  • Call insurance companies and utilize insurance websites to obtain claim status.
  • Actively follow up and collect on paper and electronic claims from insurance companies and follow up on unpaid balances.
  • Identify and correct billing errors and resubmit to insurance carriers while ensuring corrected claims and appeals are sent out to insurance companies timely (timely filing).
  • Follow protocol related to write offs and adjustments policies.
  • Identify denials trends and develop solutions to reduce denials and increase payments.
  • Actively manage all Insurance AR processes for assigned accounts, monitoring trends and notifying the appropriate staff.
  • Keep on task to meet all required deadlines and time-frames for customer and company needs.
  • Assist in the development of processes and procedures for accounts receivable as needed.
  • Respond to all insurance questions regarding AR.
  • Ensure compliance with all relevant regulations, standards, and laws
  • Respond/answer tasks, email and phone calls from insurance companies, staff, and management
  • Report and participate in company meetings, as requested
  • Process patient payments over the phone and answer patient phone calls, as needed
  • Process insurance refund requests and work insurance credits as needed
  • Acting cooperatively and courteously with patients, visitors, insurance companies, co-workers, physicians and management.
  • Able to provide extraordinary customer service to all parties interacted with.
  • Other duties as assigned by management.

Educational Minimum Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

  • High School Diploma or GED required
  • 3 years of experience in specialty insurance collections, including submitting and following up on claims
  • Experience in Physician Billing and Collections / Facility Billing
  • Proficiency with MS Office
  • Familiarity with ICD terms

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