• Work in EMR/Practice Management System and follow-up on pended or problems claims by calling insurance, inquiring online or appealing claims as necessary.
• Resolve denied claims quickly by completing review/research and work closely with the coder for that practice for resolution.
• Receive incoming calls for questions from patients and insurance companies.
• Mail out primary and secondary paper claims and complete Medicaid crossovers online.
• Review/Identify and prepare all refund requests.
• Work with patients (letter, phone calls) on claim issues.
• Review and work insurance aging report monthly on all pended claims 30 aging days and over.
• Verify benefits and/or check for Medicaid eligibility as needed.
• Meet with the Practices to review any problem claims and conduct staff education.
• Identify any trends in payment or denials from insurance companies and work with A/R Manager to resolve.
• Assist with coverage of the Receptionist Desk as needed.
• Good verbal and written communication skills required.
• Ability to maintain confidentiality.
• Ability to multitask and work in a fast-paced environment.
• Perform other duties as assigned.

Education/Certification/License:

High school diploma/GED required.

Knowledge, Skills, and Abilities:

1-2 years medical office experience preferred; insurance knowledge, medical terminology, and coding knowledge preferred; excellent communication with patients, employees, and insurance companies.

ADA REQUIREMENTS:

Physical Demands:

Climbing, Crouching, Walking, Fingering, Balancing, Grasping, Stooping, Reaching, Pulling, Lifting, and Talking

Physical Requirements:

Sedentary Work - Exerting up to 10lbs of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Involves sitting most of the time. Jobs are sedentary if walking is required only occasionally and all other sedentary criteria are met.

Visual Acuity:

Biomedical/Equipment Operators, Inspection, Testing, Analysis, Close Assembly, Clerical, Administrative

Environmental Conditions:

None. The worker is not substantially exposed to adverse environmental conditions such as typical office administrative work.