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Purpose: To review accounts with outstanding balances and determine correct action to be taken to insure maximum reimbursement. To take corrective action on accounts with outstanding balances in a timely manner to obtain reimbursement. To work all correspondence relating to the financial status of an account. To report all trends for denials and reimbursement issues to management team.
RESPONSIBILITIES: (TO INCLUDE BUT NOT LIMITED TO):
• Review Aging Report (A/R) each month for assigned accounts.
• Print Request for Review (RFR) Reports for corresponding Insurance Carrier or Payer to list accounts with outstanding balances.
• To take corrective action on all accounts with outstanding balances to insure timely payment by submitting appeals, resubmitting claims or billing claims to insurance carrier or payer.
• To work Hold Reports to determine necessity of the account hold and correct action needed to obtain payment.
• To work all correspondence from patients and insurance carriers or payers, taking necessary action to obtain payment.
• To understand the procedures and laws for specific insurance carriers or payers related to specific research position.
• To stay informed of changes with the procedures and laws for the specific insurance carriers or payers.
• To make clear documentation in the comments section of every account when any action is taken, indicating the action and next step to resolution.
• To follow-up on all accounts every 30 days where action was taken to insure payment is received.
• Responsible for managing work flow of the assigned account and prioritizing the issues to meet all deadlines for filing and maximum reimbursement.
JOB REQUIREMENTS:
- Medical terminology and medical billing experience.
- Medical A/R collections experience preferred.
- Excellent customer service skills.
- Ability to handle heavy phone usage with headset equipment.
- Maintain professional composure both internal and external sources.
- Good written and verbal communication skills.
- Ability to meet productivity and quality standards.
- Ability to meet time deadlines and maintain an organized work area.
- Ability to work positively in a team atmosphere.
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