Ensure patient information is accurate and complete
Request any missing patient information
Review referrals and authorizations
Confirm patient benefits and insurance
Follow all regulations and guidelines set by Medicare state programs and HMO/PPO
Transfer insurance claims and billing data to billing software
Create both paper and electronic copies of documentation
Develop and maintain a tracking system of incoming and late payments
Monitor and date late payments
Initiate late payment notices to relevant parties
Respond to questions and complaints from patients or insurance companies
Follow-up on late or missed payment notices
Monitor and resolve financial discrepancies
Arrange payment plans and timelines for payments
File and maintain organized documentation of all billing and record
Follow set billing processes and procedures
Update and review all accounts to keep records of payments up-to-date
Required Skills:
Requirements Required Skills & Qualifications: Proficiency in medical coding including ICD-10-CM CPT and HCPCS coding systems. Knowledge and experience in patient eligibility payer class insurance type and subscriber requirements for appropriate claim validation and billing submissions required Strong analytical skills and attention to detail. Excellent communication and interpersonal skills for interacting with providers staff and insurance representatives. Ability to manage multiple tasks and prioritize effectively. Experience with electronic medical records (EMR) systems preferred. Familiarity with insurance guidelines and compliance standards.
Required Education:
Education & Experience: Certification as an AAPC Certified Professional Coder (CPC or CPC-A) Required FQHC Coding and Billing Knowledge Preferred but not required High school diploma or GED required; Bachelors Degree and/or advanced education or relevant coursework preferred. Minimum of 1 year of experience in medical coding
IT Services and IT Consulting