Process all denied and unpaid claims submitted to insurance carriers to ensure payment is received.
Duties and Responsibilities
1.Review denials on an explanation of benefits (EOB) statement and work on issues until resolved
2.Analyze A/R (Accounts Receivable) reports to follow up on unpaid claims
3.Send out appeals on claims that require an appeal
4.Submit any required documentation to insurance companies as requested
5.Research the claims for information in order to process bills in a timely manner
6.Communicate with insurance companies, adjustors and patients on a regular basis
7.Correct any errors and resubmit all unprocessed or returned claims to insurance companies
8.Create UB92 and HCFA bills by performing data entry into the billing software
To perform this job successfully, an individual must be able to perform each duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities perform the duties.
Education (Degrees, Certificates, Licenses, Etc.)
High School Diploma or equivalent combination of education and experience required.
Prior word processing, spreadsheet and internet software experience including proficiency with MS Excel and MS Word required.
One to two years related billing experience preferred.
Specific Job Knowledge, Skill and Ability
1.Ability to add, to subtract, multiply and divide in all units of measure; this ability will encompass using whole numbers, common fractions and decimals
2.Ability to compute rates, ratios and percentages
3.Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedural manuals
4.Ability to write routine reports and correspondence
5.Ability to communicate effectively verbally and in writing
6.Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form
7.Ability to deal with problems involving several concrete variables in standardized situations
8.Specific vision abilities required by this job include close vision
9.Ability to sit for prolonged periods of time, use hands, talk, hear and occasionally walk and reach with hands or arms
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