- Prepare and submit clean electronic claims to maximize reimbursement.
- Analyze claim rejections and take corrective action to ensure resubmission success.
- Process all incoming payments from insurance and patients, ensuring accurate posting.
- Manage outstanding balances by following up with insurance companies, processing rebills, and escalating complex issues.
- Review and address denied claims, resubmitting when appropriate or initiating appeals.
- Reconcile patient and insurance credit balances to facilitate timely refunds.
- Serve as the first point of contact for patient billing inquiries, addressing concerns and escalating as needed.
- Collect patient co-pays, coinsurance, and deductibles.
- Develop and manage patient payment plans, ensuring timely settlements.
Requirements
- 5 or more years of experience working medical denials
- Experience working in EPIC required
- Experience working with Medicaid and Commercial payors
