Performs a variety of collection, denial and credit resolution in accordance with standard procedures. Responsible for meeting daily production and quality standards. Process routine requests received from internal or external sources including telephone, mail, and electronic communication.
Document and enter information into appropriate systems. Create backup to scan or file in order to maintain patient records in accordance to insurance regulations. Routinely refer to policies and procedures. Communicate any non-compliance to appropriate person. Retrieve assigned work from various system applications and / or Excel and prioritize work per current procedures. Read and understand the Explanation of Benefits to determine why an account has a denial or outstanding balance and solve the denial or outstanding balance. Communicate with insurance companies to determine status of payment or reason for denial. Process adjustments on accounts as necessary. Research and resolve overpayments. Process reconsideration / appeals on accounts as needed. May participate in special projects as requested.
Candidate should have data entry/clerical experience.