Responsible for reviewing, processing and investigating insurance claims to assure receipt of maximum reimbursements available. Investigates a large volume of denied claims to discover errors that may have caused denial, makes corrections and resubmits claims. Errors may include incorrect procedure coding, incorrect insurance information, technical difficulties in electronic billing systems. Works mainly with an assigned group of insurance providers. Coordinates benefits between primary and secondary insurance providers. Processes incoming checks and posts charges to patient accounts. Reviews monthly accounts receivable aging reports, re-bills patients as necessary. Complies with clinic policies and procedures on regular work attendance. Communicates with patients and insurance companies via the telephone to effectively resolve account questions and complaints and to clarify insurance coverage. Occasionally meets with patients in person. Investigates changes in insurance coding or policies through review of web-sites, manuals, newsletters and attending meetings. Applies changes as appropriate based on information gathered. Educates co-workers on changes when necessary. Prepares miscellaneous correspondence to insurance companies such as letters of medical necessity, orders for physical therapy. Verifies demographic and insurance information for outreach patients. Takes payments on accounts either in person or over the phone. Provides back-up to switchboard operator and other business office personnel as needed, which may include answering phones, opening mail, and other miscellaneous duties.
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Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED