Responsibilities:
- Oversight of Revenue Cycle and accounts receivable of multiple provider offices/care centers
- Analyze claim denials for coding or payor policy updates and make corrections as needed
- Review coding or documentation from provider that may need to be updated to release for billing
- Generate appeals or reconsideration forms on denied claims utilizing web portals or payor specific forms
- Help develop claim edits that will help increase cash flow and create clean claims
- Follow up on authorizations initiated by the front office staff, when necessary
- Research and provide timely response on patient, insurance and physician inquiries
- Communicate with provider's offices to discuss accounts receivable issues, payment or denial trends and make recommendations to impact change.
- Run denial and accounts receivable reports to help identify trends
- Coordinate with internal departments, escalate and resolve payment issues
- Communicate with patients regarding billing issues, when requested
- Other duties as assigned
- Minimum of 2 years’ experience in medical insurance processing required
- CPC/CCS medical coding certification preferred
- High school diploma required
- Combination of college degree may be substituted for some level of experience
- Previous experience working in an OB/GYN environment highly desirable
- Proficient in Athena Health highly desirable
- Highly organized and detail oriented
- Excellent oral and written communication skills, with ability to effectively communicate with all levels within the organization
- Demonstrated ability to work in a fast-paced office environment.
- Advanced Microsoft Office skills required. Microsoft Excel proficiency preferred.