Working knowledge of CPT, HCPCS, and ICD-10 coding (required)
Advanced knowledge of denial types and resolution steps
3 years related experience (required)
Strong computer and keyboarding skills
Strong communication and problem-solving skills
Proficient with data entry and multitasking in a Windows environment
Desired experience with Microsoft Office Software (preferred)
Ability to meet productivity and quality standards
Ability to communicate verbally/in writing with professionalism
Familiar with Echo and Paceman
Familiar with Epic
Responsibilities:
Experienced in calling payers and doing the research we well as re-processing claims
Able to complete 60 cases a day with a 90% Accuracy
Monitor and execute work within the Epic Work Queues
Research and resolve claim denials or rejections based on work team assignment
Key claim detail information into various payor websites, upload medical records to various websites to resolve denials
Follow up with correct insurance companies for claims with no response or for claims denied due to incorrect insurance information or denials for authorizations.
Update charges and refile electronic or paper claims as needed. Follow up on calls or emails from Patient Financial Specialists, concerning patients requesting advanced assistance with their accounts.
Inform management and relevant organizational stakeholders of correspondence and communication problems with service locations.