Insurance Claims Processor
18 hours ago
Responsibilities:
The AR Follow-up Specialist will play a key role in managing and collecting outstanding accounts receivable within the revenue cycle management process.
- Key Tasks:
- You will verify patient eligibility and benefit verification through calls and web portals.
- You will review and verify medical codes, including CPT, ICD-10, and HCPCS.
- You will transmit corrected claims electronically or by paper according to payers' requirements.
- You will monitor and follow up on unpaid or denied claims to ensure timely resolution.
- You will contact insurance companies to inquire about claims status and facilitate payment.
- You will review aging reports regularly to prioritize and address delinquent accounts.
- You will initiate appeals for denied or underpaid claims and track the appeal process.
- You will develop denial management strategies to minimize future denials.
- You will maintain detailed records of appeals.
- You will understand insurance policies, reimbursement methodologies, and billing guidelines.
- You will collaborate with billing and coding teams to address recurring issues.
- You will investigate and resolve discrepancies in payments, adjustments, or denials.
- You will identify claim processing issues and general billing trends.
Requirements:
- Bachelor's Degree from a reputable institution or university.
- 1 to 2 years' experience in medical billing - accounts receivable and denial management.
- Knowledge and understanding of USA health insurance guidelines, especially Medicare and state Medicaid.
- Experience in Pain Management, Lab, Anesthesia, Psych/TMS, RTM, CCM.
- Strong communication skills are essential.
- Must have a strong grip on MS Office.
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