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.
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