Must be able to work independently and initiate processes when no direction is given. Follows Patient Financial Services policies to achieve maximum reimbursement while promoting excellent relationships with clinical departments, patients, physicians, physician offices, payers, and employers. 3d agoĭirectly responsible for obtaining appropriate treatment authorizations from payers for outpatient surgeries, outpatient diagnostic services, observation patients and potential direct admits. * Associate's Degree (A.A.) $27k-32k yearly est. * Knowledge of Word Processing software, Spreadsheet software and E-mail software * Minimum two (2) years' work experience with insurance claims and handling billing experience with UB or state specified form. ![]() * Ability to perform all other duties as assigned or requested * Informs Billing Managers of any charging trends or edit trends and provide examples/education to other departments to reduce errors * Documents actions taken in collection system * Reviews patient account information for accuracy in billing * Audits claims/accounts for charges, duplications, and overlapped accounts prior to billing, making any necessary adjustment * Investigates rebill requests submitted to the billing department and processes these requests when appropriate * Evaluates electronic insurance rejections in order to re-transmit with corrected claim information * Processes claim updates based on direction given by facility or coding liaisons * Ensures accurate and complete clean claim submission for both paper and electronic claims ![]() * Analyzes, researches and processes insurance claims through electronic claims management systems in a timely manner. The position is also responsible for completing requests for rebilling of denied claims. This position will be responsible for processing of claims via electronic management system by reviewing identified errors or rejections and resolving these issues appropriately.
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