Revenue Cycle Medical Billing IDR Claim Status - Located in West Plains, MO

Essential Functions/Duties

• Verifies the status of claims that have been billed to insurance on a timely basis according to the productivity guidelines for Claim Status goals.
• Makes claim inquiries via online portals, telephone, email, etc., and multitasks on accounts when on-hold over the phone.
• Maintains daily and monthly departmental production goals set forth by the supervisor to ensure that the company is achieving its financial goals.
• Identifies, documents, and communicates trends in recurring rejections and denials to the supervisor.
• Recommends process improvements or system edits to eliminate future denials.
• Pursues unpaid accounts by telephone or electronic inquiry to determine status of payment in accordance with department follow-up timelines.
• Documents all account activity in an accurate and timely manner for all touch points made on any patient account.
• Contacts patient for additional information when necessary to push the claim through for payment.
• Sets up and submits requested additional information/documentation at payor request for claims to process accordingly.

Education Requirements

• A high school diploma or equivalent is required.
• Significant relevant work experience may substitute for formal education.

Skills Requirements

• Knowledge of health care billing procedures, reimbursement, third party payer regulations, documentation, and standards.
• Understanding and interpretation of Explanation of Benefits (EOB) from payors.
• Strong problem-solving skills, attention to detail, and ability to make timely decisions.
• Excellent internal and external customer service skills.
• Responsiveness and a strong commitment to meeting internal and external deadlines with limited supervision.

Qualifications

• Must be fluent in English.
• Minimum of one (1) year of medical billing experience.
• Professional written and verbal communication skills.
• Knowledge and experience of computers and related technology.
• Ability to work independently with little or no direction and as a member of a team.

Preferred Experience

• Minimum of one (1) year working in a call center environment.
• Above average knowledge of insurance billing guidelines and policies.
• Experience with Commercial Insurance processes and policies.

Benefits

Check out our careers site benefits page to learn more about our benefit options.