• Claim Tracking: Check the status of unpaid or pending claims using payer websites, portals, or phone calls.
• Denial Management: Research and resolve claim denials or rejections by reviewing codes, contracts, and medical records.
• Appeals and Resubmissions: Write and submit appeal letters or correct claims to overturn denied claims and secure payment.
• Account Documentation: Write clear and concise notes in the billing software for every action taken on an account.
• Communication: Talk to insurance companies, patients, and internal departments to fix demographic or billing errors. Alert management to trends and issues needing escalation.
• Adjustment Requests: Identify and request adjustments to insurance and patient balances.
• Productivity/Quality: Ability to maintain productivity and quality as set based on department policies.
• Confidentiality: Ability to follow HIPPA guidelines and policies an maintain PHI integrity.
• Teamwork: Ability to work as a team player in department as well as with other departments as tasked/assigned.