Job Description

Job Title

Maintains productivity and accuracy metrics per department expectations. Responsible for working claim errors in claims management system ensuring clean claims are submitted timely to insurance carriers. Reviews insurance rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding rejections. Correct and identify billing errors and resubmit claims to insurance carriers. Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans. Assist in identifies and communicating trends and/or potential issues to management team. Payer website user access maintenance. Responsible for system maintenance of Athena master files including referring provider information, accurate insurance plan information and payer enrollments. Responsible for EDI, ERA and EFT enrollments for all payers.

Education

• High school diploma or GED

Experience

• Minimum two to three years of experience in medical billing. Experienced candidates will have prior experience working claim errors in a claims management system. Prefer candidates with knowledge of ERA/EFT enrollment as well as ANSI formatting.

Requirements

• Requires demonstrated knowledge of revenue cycle applications. Prefer prior experience configuring revenue cycle vendor-supplied software.

Knowledge

• Knowledge of ICD-10, HCPS, and CPT codes, medical terminology, and billing practices.
• Advanced computer knowledge, including Window based programs.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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