Summary:
Under general supervision of the Follow-up Supervisor performs all duties necessary
to follow up on outstanding claims and correct all denied claims for a large
physician multi-specialty practice.
Responsibilities:
Review all denied claims correct them in the system and send corrected/appealed claims as
written correspondence fax or via electronic submission.
Identify and analyze denials and enact corrective measures as needed to effectively
communicate and resolve payer errors.
Continually maintain knowledge of payer specific updates via payer’s listservs provider
updates webinars meetings and websites.
Understand and maintain compliance with HIPAA guidelines when handling patient information
Contact internal departments to acquire missing or erroneous information on a claim
resulting in adjudication delays or denials.
Report to supervisor identification of denial trends resulting in revenue delays.
Answers telephone inquiries from 3rd party payers; refer all unusual requests to
supervisor.
Retrieve appropriate medical records documentation based on third party requests.
Refer all accounts to supervisor for additional review if the account cannot be resolved
according to normal procedures.
Work with management to improve processes increase accuracy create efficiencies and
achieve the overall goals of the department.
Maintain quality assurance safety environmental and infection control in accordance
with established policies procedures and objectives of the system and
affiliates.
Perform other related duties as required.
Other information:

Please refer the Job description for details