EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

• High school diploma or equivalent required.
• Three or more years’ experience in related field required.
• Extensive knowledge and understanding of Commercial Insurance and Medicare/Medicaid required.

PURPOSE STATEMENT:

Responsible for accurate, timely and complete documentation regarding insurance verification, billing and collections.
Responsibilities:

ESSENTIAL FUNCTIONS

• Position is eligible for Hybrid / Remote model after 90 days. 3 days remote / 2 days in office
• Prepares and monitors monthly billing and collection processes utilizing established policies, procedures, and tracking systems
• Verifies Medicare, Medicaid and Commercial benefits and prior authorizations
• Identifies deductible, co-insurance and co-pay due per EOBs received
• Compiles appropriate information for refunds, bad debt write-offs, and adjustments
• Types, assembles, copies, files and processes data required in an accurate and timely manner.
• Making telephone calls, writing letters, and/or sending faxes to patients, insurance carriers, and other responsible parties in the pursuit of getting a claim resolved.
• Handling and interpreting medical documentation such as UB04 claim form, 1500 claim forms and EOB’s.
• Analyzing and interpreting documents, contracts, notes, and other correspondence
• Writing appeals to insurance carriers to overcome denials.
• Manage an extensive portfolio of claims by prioritizing and organizing time effectively
• Comply with privacy laws and patient’s needs.
• Overcome obstacles by using effective information gathering and problem solving methods.
• Participates in monthly AR reviews with Management Team.
  Qualifications: