Northern Arizona Healthcare · 13 hours ago

Insurance Billing Representative

Flagstaff, AZ

Contract

Remote

Entry Level

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Responsibilities

Demonstrates knowledge of editing and submitting claims to insurance clearing house by electronic or paper submission.

Demonstrates knowledge of when to send a claim to the auditor or coder for corrections.

Reviews and make corrections to rejected claims and resubmits to payers.

Open communication on Updates-CPT codes and ICD-10 codes, as needed. Works with Billing Manager to maximize revenue potential based for services and providers.

Corrects, edits and manages denied claims through work queues, correspondence and emails: May consist of Invalid CPT, Invalid DX, Missing Modifier, Bill another Carrier, Invalid Eligibility, Authorization/Referral, Documentation Required or Other open tasks requiring intervention.

Enters encounter notes, regarding rejections and follow up activities performed to enable others to review claim history on all encounters.

Performs account adjustments or write-offs as needed in accordance with the 'Write-Off' policy.

Handles internal communications with the health centers related to insurance billing and collections.

Requests medical records from health centers as requested by the contracted insurance plans.

Corresponds with and assists vendors involved with patient accounts.

Responsible for reporting any safety related incident in a timely fashion through the Midas/RDE tool; attends all safety related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.

Maintains confidentiality of all department, patient, and billing matters.

Completes all company mandatory modules and required job specific training in the specified time frame.

Stays current and complies with state and federal regulations/statutes and company policies that impact the employees area of responsibility.

Qualification

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Medical Insurance BillingMedical/Hospital BillingUB04EOBComputer proficiency