The Insurance A/R Coordinator is responsible for working oninsurance accounts receivable and payment denials. Identifies and corrects errors andresubmits claims to insurance carriers. An experienced, professional familiar with medicalinsurance appeal and denial process. Composing letters of appeals-PPOs/HMOs/Governmentinsurance plans.
Extreme familiarity with appeals language and regulations- Working theaccounts receivables- Addressing denied and underpaid EOBs- Investigating unpaid claims-Creating reports and spreadsheets for monthly reports to management. Good customer serviceand communication skills required.
Essential Functions:1. Must have good knowledge of insurance companies both in and out of network billing.2. A background in processing claims; review and preparation of claims for hard copybilling submission in the full revenue cycle.3. Must be comfortable working with different insurances and have the ability to prioritizework and to handle multiple projects.4. Thorough knowledge of medical terminology including CPT, ICD-10 and modifiers, billingrequirements, and ability to interpret EOBs.5. Must be responsible, organized, pleasant and punctual.6. Be able to address and resolve claim issues and denials in a very timely manner-7. Be very comfortable using computers and be able to learn our PM software.8. Can work independently and as part of a team.9. Identify problems with delinquencies, keeping accounts current and accurate &adjudication of denied claims- Performs other assigned duties.10. The ability to take the proper course of action based on the denials received verballyand/or in writing.11. Knowledge of insurance and claims submission & understands the Revenue CycleManagement process12. Excellent communication (verbal, non-verbal, written) and phone skills.13. Experience operating multiple software applications14. Good interpersonal skills15. Ability to multi-task and attention to detail.16. Ability to problem solve for good outcomes17. Belief that their efforts are an important piece to the patient experience.18. Promote and practice Secondary Task:1. Maintain confidentiality regarding patient/client, family, and employee in accordance withHIPAA, regulatory, professional, and organizational standards.2. Demonstrate courtesy and respect in all interpersonal relationships with clients, staff, and visitors.
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