Minimum Knowledge, Competencies & Qualifications:
•Able to understand professional / technical billing and reimbursement processes.
•Updates practice score card weekly.
•Reviews physician alignment accounts receivable.
•Reviews Explanation of Benefits (EOBs) for denial reasons and determines the applicable course of action.
•Able to differentiate between clinical and technical denials through EOBs, letters and patient data.
•Able to communicate with third party vendor to identify appeal status and outcome.
•Ability to review Close Out and Concurrent reports from third party vendor.
•Ability to review and analyze third party vendor invoices on overturned denials.
•Reviews and adjusts accounts according to prompt pay discounts and contractual adjustments to ensure accurate processing of claims
•Ability to work well individually and in a team environment.
•Able to work in a professional, corporate setting.
•Advanced proficiency on MS Office suite with emphasis in Excel.
•Excellent oral and written communication skills.
•Sound analytical skills.
Atlantic Health System - 11 months ago