Prebilling/billing and follow-up activity on open insurance claim exercising revenue cycle knowledge (i.e., CPT, ICD-10 and HCPCS, NDC, revenue codes, and medical terminology).
Will obtain the necessary documentation from various resources. Ability to timely and accurately communicate with internal teams and external customers (i.e., third-party payors, auditors, and other entities) and acts as a liaison with external third-party representatives to validate and correct information. Comprehends incoming insurance correspondence and responds appropriately.
Identifies and brings patterns/trends to leadership's attention regarding coding and compliance, contracting, claim form edits/errors, and credentialing for any potential delay/denial of reimbursement.
Obtains and keeps abreast with insurance payer updates/changes, and single case agreements and assists management with recommendations for implementation of any ...