Performs the review and confirmation of work orders prior to billing, by verifying accuracy of order and required documentation such as prescriptions, certificates of medical necessity, prior authorizations, diagnosis and procedure codes. Monitors the confirmation work queue to ensure timely confirmation of work orders. Tracks incomplete information and communicates feedback to management and intake staff. Works accounts receivable aging reports performing follow up in accordance with policies and procedures. Generates and processes statements and claim forms in an accurate and timely manner. Obtains, verifies and maintains customer demographics and insurance information for billing purposes. Works to resolve carrier denials and correspondence for proper payment of claims. Shares responsibility through timely communication of identified problems to assure proper follow up is completed to expedite claims and ensure proper payment. Identifies potential discrepancies in claims payment processing. Answers questions and resolves problems related to billing operations. Provides clear documentation of all communication related to accounts in account or claim notes. Reviews credit balance accounts on a monthly basis. Prepares appropriate paperwork when refunds are warranted, based on history of account and contractual agreements; forwards to Lead Billing Account Specialist for approval and processing. Assists clients with questions, payments and account resolution. Makes payment arrangements and processes statements and takes collection measures when necessary. Maintains current knowledge of carrier specific requirements by attending workshops, reading newsletters and acting as liaison in carrier meetings. Provides communication and teaching to Billing Account Specialists, Payment Posting Specialist and Billing Records Technician.
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Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED