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Form of work
Salary` Essential Duties and Responsibilities:
1. Utilizes the Claims Management System to review all unpaid claims for Payers.
2. Utilizes the MCO’S portal to look up claims and eligibility to resolve billing issues.
3. Utilizes Medius to research EVV Data when there is an issue with the claim not matching the EVV data.
4. Utilizes Availity to look for claim information when resolving billing issues.
5. Reviews denials on Explanation of Payments in order to prepare corrected claims and appeals.
6. Communicates with MCO’S customer service representatives regarding denial codes on the EOP’S when further explanation is needed to determine what is wrong with the claim.
7. Communicates with MCO’s provider relation representatives when the MCO’s customer service representatives do not provide adequate information in resolving billing issues.
8. Communicates with the authorization department to resolve billing issues.
9. Prepares write offs in the Claims Management System after it is determined that a claim is past timely filing. .
10. Meets with management regularly to discuss billing issues
11. Review’s transmittal and response files from the Aggregator to solve billing issues.
12. Understands MCO claim and appeal deadlines.
13. Works claims patient by patient by service dates to ensure no past timely issues
Job Type: Full-time
Pay: From $16.00 per hour
Expected hours: 40 per week
Benefits:
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Weekly day range:
- Monday to Friday
Work setting:
- Office
Work Location: In person
