*Job description*
To function as a member of the clerical team performing a supportive role in the delivery of patient care that is safe, effective, patient-centered, timely, efficient, and equitable.
* Perform claims resolution and/or medical billing and reconsiderations/appeals or claims denials in Centricity.
* Conduct AR follow-up on back-end denials.
* Understand the process and order of how to contact insurance carriers and have the claims reprocessed, and then move onto to a reconsideration, and then the different levels of appeals.
* Demonstrate a detailed understanding of how to read and interpret EOB's and denials from all insurance carriers (including the financial components such as co-pays, deductibles, and co-insurance).
* Possess a thorough knowledge of appeals processing from beginning to end across all payer categories based on insurance denials.
* Differentiate between best practices of appeal, coding review, credentialing review and/or adjustment.
* Be able to follow up on claims worked within the last 30 days to ensure they are reprocessing, or the appeal records were received and are in queue to be reviewed.
* Contact insurance companies and utilize web portal and websites for appeal, eligibility, remittance, and payment information.
* Candidate must be able to report and communicate issues and trends.
* Have an understanding of an A/R and know how to handle the A/R as far as which claims to work first and put as priority.
* Have a steady workflow and be able to present to Revenue Cycle Manager and Director of Operations where you are with Insurance AR.
* Excellent organizational, communication & time management skills.
* Assist Front Receptionist with daily task and coverage PRN.
* *Knowledge/Ability to:*
* Establishes and maintains positive interpersonal relationships and promotes effective teamwork with patients, families, coworkers, and the community to meet customer service goals.
* Demonstrates effective use of medical terminology and EMR system.
* Demonstrates knowledge and awareness of policies and procedures.
* Demonstrates effective problem solving, critical thinking, planning, and decision-making skills.
* Able to handle stressful or difficult situations.
Demonstrates dependability and initiative as a member of a team.
* Demonstrates effective customer service skills and communication skills (verbal and written).
* Demonstrates effective time management skills including priority setting.
* Ability to multi-task in a fast-paced setting.
* Ability to interact with diverse groups of patients, members of the public and other healthcare providers.
* Ability to follow instructions as directed and to ask for clarity if not understood.
* Job Type: Full Time We are an Equal Opportunity Employer
Job Type: Full-time
Benefits:
* 401(k)
* 401(k) matching
* Dental insurance
* Health insurance
* Life insurance
* Paid time off
* Vision insurance
Schedule:
* 8 hour shift
* Day shift
* Monday to Friday
Experience:
* ICD-10: 1 year (Required)
* Medical Billing: 3 years (Required)
Work Location: In person
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