Claims Processor I - Remote
About the position
Responsibilities
• Account maintenance: Updating registration, authorization issues, identifying charge correction, debit or credit memos, processing adjustments as needed and denial follow up according to payer rules and departmental policies.
• Use electronic billing system appropriately to follow up on outstanding denied claims and all no response claims.
• Correct claims in electronic billing system for missing or invalid insurance or patient information according to procedures, and place account on hold if unable to resolve.
• Follow up on denied or no response claims by calling third party payers or using payer websites.
• Gather information from patients or other areas to resolve outstanding denied or no response claims.
• Research accounts to take appropriate action necessary to resolve.
• Keep management aware of issues and trends to enhance operations and escalate slow-pay issues to managerial level when necessary.
• Use payer websites to stay current on payer rules and changes.
• Maintain 90% quality standards on account follow and activity.
• Maintain productivity standard as set forth by management team.
• Other duties as assigned.
Requirements
• High school diploma required.
• One year of billing and insurance follow up in a hospital or physician office setting preferred.
• General working knowledge of insurance terminology and billing rules.
• Able to prioritize work on a daily basis.
• Requires independent judgement in handling patient accounts.
• Direct supervision available on a daily basis as conditions may require.
• Knowledge of Epic preferred.
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