Reviews patient registration, insurance, and third party payments in the medical billing system.
Confirms charges are entered into the medical billing system accurately and correctly for reimbursement.
This includes: correct CPT codes, and ICD-10 codes, authorizations for services, patient demographics, and required medical record data.
Resolve claim edit errors, such as missing patient demographics, coding and insurance information errors.
Identify and apply corrective action.
Determine cause of errors and make recommendations for improving the process towards effort of reduce pending unbilled charges.
Manage inquiry queues and respond, as applicable, timely and accurately.
Must maintain 95% accuracy rate in submitting a clean claim which could result in inaccurate or delayed reimbursement.
Achieves goals set forth by supervisor regarding error-free work, transactions, processes and compliance requirements.
Communicate Client/Vendor/Payor trends to Supervisor as applicable.
Ability to handle multiple priorities at one time, ability to work independently with minimum of supervision and ability to manage and prioritize work queues and paperwork accurately under pressure of Client deadlines.
Participates in staff meetings, trainings, and conference calls as requested and/or required.