Medical Claims

KEY RESPONSIBILITIES: * Various aspects of medical billing; claim creation, claim submission, payment posting for insurance and patient balances in the athenaNet system

• Obtain supporting documentation (medical records, EOB’s, remits, authorizations, referrals), from the multiple systems.

• Monitor insurance denials by running reports and contacting insurance companies to resolve and recover denied claims

• Monitor aging reports for timely follow-up on unpaid claims

• Retroactive review of registration data to aid in the assurance of clean claim submittal

• Accurately document actions taken within patient account

• Serve as resource for problem solving issues related to registration, demographic and insurance errors

• Work payer correspondence including support tickets, emails, and phone message from internal and external contacts

• Work collaboratively with Coding, Provider Enrollment, and Cash Posting as well as coworkers, Team Leads, Managers and practice staff to resolve claim and account issues

• Adhere to HIPAA guidelines regarding confidentiality relating to the release of financial and medical information

• Follow state, federal, insurance and organization guidelines

• Additional duties as assigned

Required experience:

• Medical Billing: 1 year