Job Responsibilities

• Resolves higher dollar, aged accounts receivable to determine why a claim has not be paid and takes necessary actions to get claim paid immediately.
• Promptly resolves denials by identifying the root cause of the issue and then taking any necessary actions to get denial overturned and paid promptly.
• Works with payers, departments, management and patient (if required) to obtain necessary information for claim resolution.
• Provides feedback to supervisor and ensures collecting the information of trends and responds to inquiries about trends.
• Performs any necessary account adjustments in accordance with department policies.
• Ensures assigned work queues are reviewed and resolved timely.
• Monitors assigned work queues and payers for identification of potential problems.
• Proactively escalates unresolved questions or issues. Shares information as necessary.
• Other duties as assigned.

Education Requirements

• High school diploma or GED

Experience Requirements

• Minimum: Two (2) years of experience working with insurance balances in a business office or similar role.  
• Preferred:  Three (3) years of insurance follow-up experience working in Epic EMR handling claims of moderate to high complexity

License/Certification Requirements

•  Minimum:  None