Job Summary:

Analyzes claim denials and executes follow up to recover payment Assists with provider credentialing and payor enrollment to maintain provider status and research denials Coordinates with multiple departments as needed to determine the root causes of denials Maintains a tracking log to monitor post-payment review findings and appeals Identifies patterns in payor denials and reports recurring issues to management Assists with claim submission, follow-up, and reporting needs throughout the clinically driven revenue cycle Submits payer reconsiderations and appeals as necessary and completes follow-up for final resolution Assists in the clinical revenue cycle to achieve the maximum appropriate reimbursement Retrieves paper and electronic claims and remittance advice reports where necessary to overcome denials Enters accurate and thorough documentation of pertinent events regarding the handling of the denial Meets established production standards Works in a collaborative fashion with the office, billing, and coding staff to improve overall processes

Education:

High school diploma required. Some college coursework in a healthcare, business, or related field preferred.

Experience:

Minimum three (3) years working in Medical Billing.

Additional Skills/Abilities:

Must be self-directed / self-motivated; must have good communication and interpersonal skills.

Must be able to:

(1) perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure; (2) work independently; (3) recognize the rights and responsibilities of patient confidentiality; (4) relate to others in a manner which creates a sense of teamwork and cooperation; and (5) maintain a customer focus and strive to satisfy the customer's perceived need.