Insurance Billing and Insurance Collections. Reviewing patient statements and working closely with patients to collect on open balances.
• Review/update demographics and patient information for accuracy.
• Working knowledge of appropriate coding systems; CPT, ICD-10 and HCPCS, coverage; LCD/NCD and reimbursement associated with such codes.
• Processing, validation of payer requests and processed claims via correspondence, remittance advice and EOBs (i.e., identification of payment discrepancies, inappropriate requests)
• Investigate all denied services to determine the reason for the service denial, appeal, if appropriate. Identify and report root causes associated with denials.
• Timely, effective processing of assigned appeals including development, submission, tracking, reporting and evaluation of appeal outcomes (i.e., next steps, improved outcomes)
• Maximize utilization of Billing system, tools, and resources to support cash collection activities.
• Review and work various reports including aging, adjustments, and credit balances.
• Comply with Federal and State legislation pertaining to all billing related matters.
