• Reviews payer EOB’s but not limited to payment accuracy, patient liability, and appeal grievances.
• Work 60 accounts daily
• Files appeals on denied claims and/or forwards to the Nurse Auditor for review
• Process incoming mail correspondence from payers within 5 business days.
• Follow up with the insurance companies by phone and or web for the status of outstanding claims.

• Follow up with all insurance companies within 30 days of billing if there is no payment on the account.
• Enter detailed notes explaining account activity in the Patient Accounts system

• Respond to patient inquiries regarding the status of the patient’s insurance within 2 business days.

• Forward patient complaints regarding care to your supervisor for entry into the appropriate resolution pathway.

• Accept payments over the phone.
• Research late charges to determine the cause; inform your supervisor if they are a regular occurrence.

Education

Required:

High School

Licenses & Certifications

Preferred:

C-Heartsaver