Job TitleQualificationsEducationHigh school graduate or equivalentExperience/SkillsAthena experience preferredPossesses knowledge of business office operationsUnderstands third party billing requirementsUnderstands Medicare/Medicaid inpatient and outpatient billingStrives for customer satisfaction when responding to all patient/customer inquires (internal customers)Experience using office equipmentAdapts professionally to changes in procedures and/or workloadPossesses excellent written and oral communication skillsWorks independently with little supervisionMaintains concentrationRemains committed to a "cross training" philosophy for all assigned tasksWorking ConditionsWorks in a well-ventilated, well-lit general office environmentWorks well under pressure with attention to time constraintsRoutine ResponsibilitiesBehavioral ExpectationsConsistently complies with established Behavioral ExpectationsEssential DutiesReviews, identifies, and corrects claims issues identified in inhouse hold and the claim scrubbing holdsSends clean, timely claims out on first billingWorks reconciliation desktops to ensure upfront rejection of claims are processed and resubmitted to correct payerReviews assigned outstanding accounts receivable by using ATB, queues, and payment reportsSubmits timely and accurate adjustments documenting activity in accountUnderstands and manages denials, submitting timely disputes and appealsFollows up with insurance companies to ensure claims are processed and paid correctly according to contractUnderstands payor contracts and billing guidelines. revenue codes, cpt codes, modifiers, and payor-specific guidelinesInvestigates and reports claims denial trends with payer documentation for departments to review and establish action planProvides back-up phone support to billing lines dailyFull time/Day shift 80 hours/Biweekly