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Lead Financial Analyst
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- Audits work daily performed appropriate International Classification of Diseases (ICD-10) and Current Procedural Terminology (CPT-4) codes, clinical rate; payments posted to accounts and denied or reduced payment compliance guidelines.
- Contact the insurance company or its designated reviewing organization to obtain pre-certification approval prior to admission or same day surgical procedure.
- Run reports weekly from ABACUS to identify errors and call vendors to correct such errors.
- Provide recommendations on Third Party Collection Program (TPC), Uniform Business Office (UBO) compliance that follow medical documentation and billing rules and standards.
- Reconciling accounts accurately in a timely manner in ABACUS/General Ledger according to the UBO Guidelines and the patients' specific health benefits policy.
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