Description

Description Responsible for ensuring unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and researches refunds. Monitors and ensures that collections, net, gross and days in accounts receivable targets are met. Responsibilities 1. Follows up on submitted claims, monitors unpaid claims and resubmits claims with appropriate corrections and documentation. 2. Works declines and processes appeals. 3. Responds to patient and third party inquiries; researches and resolves simple to moderately complex issues; corrects errors and refers complex issues to supervisor. 4. Reviews correspondence and rejection data from insurance carriers; posts rejections and performs reconciliations. 5. May transfer secondary balances to appropriate financial class and provides documentation for processing the claims. 6. Reviews Credit Letter Sent (CLS) and transfers balance to appropriate financial class and dunning level. 7. Reviews, works and clears electronic and claims edits daily; summarizes and forwards non-workable edits to supervisor for resolution. 8. May process refunds for supervisory approval. 9. ...