Job Activity/Duties:

• Enters information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information.
• Ensures claim information is complete and accurate.
• Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form.
• Answers patient questions on patient responsible portions, copays, deductibles, write-off’s, etc.
• Follows up with insurance companies on unpaid or rejected claims.
• Resolves claims issues and re-submits claims when required.
• Prepares appeal letters to insurance companies in disagreement with claim denial.
• Collects necessary information to accompany appeal.
• Ensures patient statements are mailed on a regular basis.
• Works with patients to establish a payment plan for past due accounts in accordance with practice policies.