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The Billing Representative is responsible for the validation of charge data received from the clinic settings, creation and submission of complete and accurate claims, follow-up on claims status, payment accuracy, appeals and correspondence.
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We are looking for a candidate with previous medical office billing experience using medical software and electronic systems such as Availity, Trizetto, NexTech, Palmetto and Tricare. They will follow up on all insurance claims and submit appeals as needed.
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The Patient Account Representative has an extensive knowledge of billing, accounts receivable follow-up, timely filing guidelines and the ability to effectively review remittance advices and electronic billing reports from payer to determine the action required.
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Insurance Verification Coding procedures and surgeries Entering charges with correct billing code Previous work with denied claims from insurance companies Handle appeals from insurance company This is a temp to hire position - benefits available after temp to hire hours are met.
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Maximizes revenue by monitoring claims and remittances, filing appropriate appeals, and processing denied charges. Answers all billing calls from patients. The Accounts Receivable Specialist - Bilingual is responsible for the follow-up of 3rd party claims, correspondence, credits, and denials.
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Minimum of two (2) prior related experience (medical coding, private insurance, laboratory and/or medical billing) Communicate with Team Lead and/or A/R Supervisor on areas that may be improved and appeals minimized.
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Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing.
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Forwards copy of Explanation of Benefits to appropriate personnel, underpay explanation of benefits to Appeals Coordinator or Collector, Overpayment to Refund Analyst and secondary payment request to Billing Coordinator.
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The Appeals Specialist will obtain, manipulate, and analyze data from a variety of resources including but not limited to hospital/physician billing systems, external contract/claims management and work with departmental personnel.
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Additional responsibilities include supporting pre-or post-payment coding audit for benchmark and/or reimbursement recovery, and other coding-related activities such as pre-appointment chart audits for HCC or risk adjustment, appeals of denied claims, providing information or education to providers for specificity of documentation to align with the coding guidelines to comply with federal, state, and regulatory requirements.
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JOB SUMMARY At Houston Methodist, the Manager Revenue Cycle position is responsible for the daily management of the staff and operations for one or more of the following areas of Revenue Cycle, to include but not limited to: insurance billing, collections, patient account resolution, appeals/denials, customer service, cash applications, revenue integrity, etc.
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Proven experience with high cost biologics and in-depth knowledge on issues related to billing, coding, appeals across physician types. The Field Reimbursement Manager (FRM) proactively provides education and support on product access programs for physicians and their staff.
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Works with team members in billing, revenue integrity, and/or the Medicare Service Center to resolve alerts/edits. As an Inpatient Appeals Audit Coder with Parallon you can be a part of an organization that is devoted to giving back.
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Experience with Zoll RescueNet software or similar ambulance billing software. Proficiency in medical coding systems (ICD-10, CPT, HCPCS) and billing software. Collaborate with the billing team to identify opportunities for process improvement and optimize revenue cycle management.
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3 years Billing collections, or denials management experience and medical terminology. Claims Appeals Representative \ Remote. 3 years Billing collections, or denials management experience and medical terminology.
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billing appeals jobs
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