Responsible for correctly processing healthcare claims in order to obtain reimbursement from insurance companies, government healthcare program, and patients.

Customer Services:

• Provides exceptional customer service.
• Answering and referring inquiries within scope of business services.
• Telephone: Answers telephone, processes call, and document appropriately. Returns all messages in a timely manner.
• Maintains communication between medical providers, administrative staff, and/or patient/families.

Business Services:

• Assigns ICD-10, CPT, and HCPCS codes based on provider documentation.

• Reviews charges entered by providers and communicates with providers possible claim issues.

• Prepares and submits claim for insurance reimbursement.

• Reviews, works, and corrects both internal errors and denials from insurance companies and re-files the claim.

• Files appeals to carriers according to prescribed guidelines, documents all information related to appeals and follows up.

• Scans and uploads patient clinical documents into medical chart.

• Ensures all provider services are accounted for and billed.

• Handles billing complaints and discrepancies.

• Assists patients with the collection of payments on outstanding balances.

Environmental Services:

• Contributes to the overall cleanliness and appearance of personal work space and department.

• Monitors supply levels and requests when needed.

• Maintains all equipment. Evaluates all equipment for damage or maintenance needs and reports when needed.

Minimum Education: High School diploma or G.E.D equivalent

Work Experience: One year or more experience in a medical office working with insurance claims.

Required License/ Certification/Registration: None

Skills:

• Communication Excellence
• Knowledge and ability to work in accordance federal and state regulations
• Ability to work tactfully and effectively with patients, family members, other employees and physicians.
• Analytical abilities
• Word Processing / Computer
• Strong customer service
• Multi-tasking
• Time Management
• Organization
• Attention to Detail
• Professionalism / Positive Attitude
• Quality Focus
• Adaptability