Maintains productivity and accuracy metrics per department expectations.
Responsible for working claim errors in claims management system ensuring clean claims are submitted timely to insurance carriers.
Reviews insurance rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding rejections.
Correct and identify billing errors and resubmit claims to insurance carriers.
Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
Assist in identifies and communicating trends and/or potential issues to management team.
Payer website user access maintenance.
Responsible for system maintenance of Athena master files including referring provider information, accurate insurance plan information and payer enrollments.
Responsible for EDI, ERA and EFT enrollments for all payers.
EDUCATION
High school diploma or GED
EXPERIENCE
Minimum two to three years of experience in medical billing. Experienced candidates will have prior experience working claim errors in a claims management system. Prefer candidates with knowledge of ERA/EFT enrollment as well as ANSI formatting.
