Job Description
Job Summary With a patient centered culture, the Insurance Claims Specialist provides a positive experience for our patients and customers by managing the patient accounts during pre and post claims processing. This management includes accurate claim submission with payee guidelines, timely accounts, follow- up and assistance with denial management issues to ensure the financial viability of Mon H
7:30 AM
Log in and pull the overnight denial queue. Your worklist shows 40–80 claims flagged by the payer in the last 24 hours. Sort by do…
8:00 AM
Start working the queue. For each denial, you're reading the remittance advice, identifying the denial reason code (CO-4, CO-50, C…
9:30 AM
Hit a complex medical necessity denial from a Medicare Advantage plan. Open the patient chart, pull the clinical documentation, an…
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