Description

Description Responsible for ensuring that 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 Follows up on submitted claims, monitors unpaid claims and resubmits claims with appropriate corrections and documentation. Works declines and processes appeals. Ensures that established billing targets for collections, gross, days in A/R and net collection ratios are met. May analyze claims system reports to ensure that underpayments are correctly identified and collected from key carriers. Works with payer and provider representatives to negotiate higher rates for claim payments. Responds to patient and third party inquiries, researches and resolves complex claims and corrects errors. Reviews correspondence and rejection data from insurance carriers; posts rejections and performs reconciliations. May transfer secondary balances to appropriate financial class and provide documentation for processing the claims. Reviews Credit Letter Sent (CLS) and transfers balance ...