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Salary- Responsible for managing daily billing functions for assigned insurance payer
- Responsible for submitting accurate coding and billing procedures to obtain appropriate reimbursement for commercial, government, third party payers, and other network entities
- Review code change requests to determine accurate coding and/or advise coding or billing changes to ensure appropriate reimbursement
- Prioritize and review denied insurance claims and resolve billing specified to unpaid claims
- Post payments and balance unapplied payments from carrier remits, self-pay
- Contact carriers and patients to maximize reimbursement on accounts to be worked
- Correct errors through TriZetto clearinghouse
- Coordinate the interaction between patients and payors to facilitate timely reimbursement
- Serve as a point of contact for billing problem solving
- In depth knowledge of payer Billing Coverage Policies and clinical billing policies
- Respond to correspondence inquiries by phone, mail for resolution
- Respond to inquiries from staff members regarding patient charges, coding and eligibility
- Maintain high level of patient confidentiality to ensure compliance with HIPAA regulations
- Communicate with management to resolve billing disputes and escalations
