![]() #Prior experience with AthenaNet billing system is strongly preferred. #Billing experience and insurance knowledge (eligibility, registration, etc.) #Must have knowledge of ICD-10 and CPT-4 coding. #Health care claims processing and follow-up background. #Experience and/or knowledge of insurance denials process. ![]() REQUIRED KNOWLEDGE # SKILLS: #Strong knowledge on third party payers guidelines and procedures required. #Additional duties as assigned by Manager. #Adheres to the HIPAA guidelines regarding confidentiality relating to the release of financial and medical information. #Assists Patient Accounts Team as needed with incoming and outgoing patient calls to resolve and collect on a patient statement. #Works collaboratively with Coding, Provider Enrollment, and Cash Posting team as well as coworkers, Team Leads, Managers, and practice staff to resolve claim and account issues. #Works payer correspondence including support tickets, emails, and phone messages from internal and external contacts. #Serves as a resource for problem solving issues related to registration, demographic, and insurance errors. #Accurately documents claim actions taken within patient account/claims. #Performs retroactive review of registration data to aid in the assurance of clean claim submittal. #Monitors aging reports for timely follow-up on unpaid claims. ![]() #Reviews, interprets and applies contractual terms and identifies and/or applies contractual and administrative adjustments.#Monitor insurance denials by running reports and contacting insurance companies to resolve and recover denied claims. ![]() These denials and appeals are billed in the AthenaNet system electronically.#Obtains supporting documentation i.e., medical records, EOBs, Remits, Authorizations, referrals, etc., through our email applications, scanning system, Medicare remittance system, and Meditech (hospital billing system). KEY RESPONSIBILITIES: #Responsible for various aspects of medical billing: claim creation, claim submission, payment posting for insurance, and patient balances. Under the direction of the Supervisor, Accounts Receivable, the Accounts Receivable Specialist is responsible for resolution of patient account balances associated with insurance denials, answer incoming insurance and practice calls with the ability to explain charges, services and insurance billing questions.# Work with practices and payers to resolve claim denials and comply with insurance and all relevant procedures, guidelines, and policies. ![]()
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