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Job Responsibility:
Performs follow-up activities designed to bring all open account receivables to successful closure and obtain maximum revenue collection
Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims
Mentors and trains new or lower level staff
Independently determines the most effective method to follow up on disputed, unpaid, underpaid, or overpaid insurance or contracted service accounts
Identifies and resolves problems related to primary and secondary accounts which are disputed, unpaid, underpaid or overpaid
Acts as a resource for questions from assigned collection and billing staff on payer policies, procedures and methods of revenue collection
Trains new staff on the use of the billing application, payer systems, and clearinghouse systems
Researches and responds to clinical department inquiries on complex, high dollar, and specialized accounts and status of collection activities
Resolves accounts identified in third party audits involving retroactive approvals, resulting in adjustments, refunds, and subsequent secondary billing
Identifies need for in-person meetings and phone conferences with third party insurance representatives due to claim and system issues
Identifies and clarifies issues that require management and intervention to avoid loss of revenue
Researches and initiates suggestions to leadership to streamline processes and training materials
Performs coverage for other positions as needed
Performs administrative office tasks and maintains records
Requirements:
Associate's degree and 3 years of relevant experience required
Or equivalent combination of education and experience