Job ID 1998
Career Level Coder
Experience 2-5 Years
Qualifications Bachelor's Degree
Roles and Responsibilities
- Work all queues, reports or pools in the assigned system on the assigned clients.
- Develop understanding of provider specialties and requirements
- Verify referrals/authorizations for denied procedures. Obtain and work with the practice to correct any referrals/authorizations for denied procedures.
- Checking insurance eligibility and benefits for patients, as needed.
- Reviewing patient accounts for accuracy and completeness and obtaining any missing information.
- Following up on unpaid claims within standard billing cycle timeframe for the client and carrier.
- Checking each insurance payment for accuracy and compliance with contract discount, as necessary.
- Calling insurance companies regarding any discrepancy in payments if necessary
- Identifying and billing secondary or tertiary insurances.
- Reviewing accounts for insurance of patient follow-up including review and research of self-pay, refund accounts for insurance.
- Researching and appealing denied claims. Coding research appeals and corrections at the discretion of the client and management.
- Answering patient or insurance telephone inquiries pertaining to assigned accounts.
- Understand CPT codes and ICD-10 codes and when these can be changed or not.
- Understand the insurance carriers requirements for submitting claims and appeals.
- Understand special situations and procedures that relate to the specialty you work on.
- Knowledge and understanding of the AR process.
- Ability to organize and prioritize work and manage multiple priorities.
- Excellent verbal and written communication skills including, letters, memos and emails.
- Excellent attention to detail.
- Ability to research and analyze data.
- Ability to work independently with minimal supervision.
- Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.
- Solid computer/technology skills.
- Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources.