Job Responsibilities
Claim Submission
Create, submit, and track claims to insurance companies (primary and secondary) electronically or by mail.
Rejection
Address rejected claims returned by the clearinghouse or payer for immediate
correction, such as invalid patient information, member ID, or missing acute
manifestation term policy, invalid diagnosis codes, incorrect procedure codes
incorrect payer ID, and other rejections.
Payment Posting
Accurately posting payments from insurance companies, including both manual and ERA posting. Ensuring correct patient responsibilities are applied, such as copays, coinsurance, and deductibles.
Accounts Receivable
Monitor and follow up on outstanding claims older than 30 days to ensure timely payment.
Denial Management
Investigate and address denied claims, such as those denied for lack of authorization, missing medical records, incorrect modifiers, terminated insurance, coordination of benefits, and other scenarios that could cause denial.
Experience: 2 - 5 years
“For years, I maxed out my hours, got burnt out, and the quality of my work would start to go down. I decided to take the leap, hire correctly, and now it frees up my time to focus on growing the business.”
Tyler Gies
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- Steven Rapposelli
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