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Facilitates the resolution/prevention of billing errors and denials including obtaining pre-certifications or referrals as needed. Conducts follow-up with patients to ensure compliance with all testing, prescriptions and the plan of care.
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Performs account analysis for claim acceptance, rejection, or denials to ensure proper payments are received and ensures all account demographics including payer information is accurate and up to date.
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May resolve issues of denials identified through adjudication, and follow-up claims in Point of Sale (POS) May produce reports and keep management informed of unpaid claims and claims pending follow-up.
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PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations. PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients.
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Knowledge of insurance follow up process, clinic operations, general office principles, medical insurance, payer contract, and basic medical terminology and abbreviations, regulatory/reporting requirements.
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Ensures PFS management is kept up to date with contract, payer or system changes and/or issues. Processes incoming correspondence, including signature letters, denials, prior authorizations and additional information necessary to process the claim.
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University of Toledo Physicians offers competitive pay and benefits including: 403B, Pension, health and tuition waiver at UT.The Insurance Follow Up Specialist performs job duties in accordance to established procedures, policies and detailed instructions, drive resolution and promote peak performance while delivering world class revenue cycle outcomes.
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Correspondence and appeal denials done in a timely manner with pro-active follow-up on appeals in process. Follow up on delayed and denied claims. We are a comprehensive medical center offering primary care, pain management, mental health and services at our ambulatory surgical center looking for a full-time medical biller/collector to add to our friendly team.
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Reviews various reports to identify denials and edits; corrects claims, suggests action plans to eliminate these denials/edits in the future, and determines appropriateness for appeal. Ensures that staff is appropriately working accounts based on accuracy, due diligence, and timeliness of follow up.
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POSITION SUMMARYThe Lead Reimbursement Specialist is responsible for all revenue cycle functions for assigned fee for service/third party facilities, including insurance verification, census, authorization management, billing, collections, cash posting, collections, denials, appeals and write offs/refunds.
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The Accounts Resolution Specialist II reports to the Supervisor of Billing; this individual specializes in the resolution of patient accounts transferred from the PBO. This position will investigate and follow up on claim edits and work denials and underpayments by insurance carriers regarding open balance to obtain payment.
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Follows up on daily correspondence (denials, underpayments) to appropriately work Patient accounts. + Documents billing, follow-up and/or assign collection step(s) that are taken and all measures to resolve assigned accounts, including escalation to Supervisor/Manager if necessary.
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401k with up to 6% employer match 10 paid holidays per year Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance.
$17.2 - $25.7Full-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Review denials and error messages in Zirmed/Waystar and follow up promptly *Follow up on ALL insurance accounts and aging reports with collection status. Review denials and error messages in Zirmed and follow up promptly.
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Accurately completes or assures completion of registration process and facilitates revenue enhancement through insurance verification, pre-authorization, verification of medical necessity and follow up of denials.
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