Description
- Reviews payer EOB's but not limited to payment accuracy, patient liability, and appeal grievances.
- Work 60 accounts daily
- Files appeals on denied claims and/or forwards to the Nurse Auditor for review
- Process incoming mail correspondence from payers within 5 business days.
- Follow up with the insurance companies by phone and or web for the status of outstanding claims.
- Follow up with all insurance companies within 30 days of billing if there is no payment on the account.
- Enter detailed notes explaining account activity in the Patient Accounts system
- Respond to patient inquiries regarding the status of the patient's insurance within 2 business days.
- Forward patient complaints regarding care to your supervisor for entry into the appropriate resolution pathway.
- Accept payments over the phone.
- Research late charges to determine the cause; inform your supervisor if they are a regular occurrence.
Requirements
Education
Required:
High School
Licenses & Certifications
Preferred:
C-Heartsaver