Ensure all internal and external phone calls (patients, staff, insurance companies, etc.) are handled in a professional manner with a customer service approach. Demonstrate an understanding of Electronic Practice Management (EPM) and Electronic Health Records (EHR) within NextGen software as it relates to insurance, demographics, and release of information associated with the daily functions of the Business Office. Understand the process from the time patient schedules an appointment, front desk procedure, coding, billing, application of payment, and collections. Work closely with patients, insurance companies, and co-workers to address or resolve any concerns while maintaining HIPAA compliance. Monitor remittance advice for details including denials and payment inconsistencies. Submit replacement claims and appeals to the insurance companies; submit timely follow up requests for status. Assists as needed in processing insurance payments so that all accounts are up-to-date and accurate. Complete insurance Payer Audits quarterly to ensure payments are accurate per our contracted rates. Run service item reports to verify correct payment/information for processing claims. Must have knowledge and understanding of CMS billing guidelines for submitting accurate information on claims. Knowledge on new insurance plans each year. Research insurance portals Maintain information from insurance bulletins Understand how to set up new insurance and update all pertinent documents in MNGI Any and all other duties as assigned.
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Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED