Job Description

Responsibilities and Duties

• Responsible for reviewing, correcting, and releasing Epic Care charges.
• Demonstrate strong understanding and utilization of Navicure clearinghouse claims tool and Navicure rejection queue.
• Responsible for researching, correcting, and releasing accounts within AFF AFC Claim Edit Billing Work queue.
• Demonstrate comprehension and implementation of claim appeal process.
• Possess knowledge of insurance, especially Medicare, rules and guidelines.
• Identify insurance company or proper party (patient) to be billed; identify and bill secondary or tertiary insurances.
• Review assigned accounts within the AFF AFC Follow up and Catch All WQs ensuring outstanding, pending, partially paid, and denied claims are paid in a timely manner.
• Communicate with health care providers, patients, insurance claim representatives and other parties to clarify billing issues and facilitate timely payment.
• Accurately file confidential correspondence and documentation.
• Review, research, and process refund requests as needed.
• Demonstrate knowledge of CPT, ICD 10, and procedural modifiers.
• Consult supervisor, team members, and appropriate resources to solve billing and collection questions and issues.
• Any other duties determined appropriate by management.