Essential Duties & Responsibilities:

Verify/obtain eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers
Update patient demographics/insurance information in appropriate systems
Research/ Status unpaid or denied claims
Monitor claims for missing information, authorization, and control numbers (ICN//DCN)
Research EOBs for payments or adjustments to resolve claim
Contacts payers via phone or written correspondence to secure payment of claims; reconsideration and appeal submission.
Access client systems for payment, patient, claim and data info
Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems
Secure needed medical documentation required or requested by third party insurance carriers
Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure
Perform other related duties as required
Minimum Requirements & Competencies:

2+ years of medical collections/billing experience
Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI
Intermediate knowledge of third-party billing guidelines
Intermediate knowledge of billing claim forms (UB04/1500)
Intermediate knowledge of payor contracts
Working Knowledge of Microsoft Word and Excel
Intermediate working knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
Must be willing to work onsite.
Preferred Requirements & Competencies:

Working knowledge of one or more of the following Patient accounting systems – EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts, or Paragon
Working knowledge of DDE Medicare claim system
Knowledge of government rules and regulations