Insurance Collection Specialist I-Westfield (Full-time)

Company Name:
RiverBend Medical Group
Major Responsibilities:
This individual will be responsible for posting payments and denials to accounts through ERA or manually, research, trend and resolve claim rejections, and assist the internal departments with billing inquiries.
Essential Functions:
Enters charges/charge corrects as needed.
Processes incoming payments both ERA and Manually. Reconcile ERA payments in work queues.
Post claim rejections both manually and ERA accurately in patient?s accounts with payor rejection returns as priority.
Process claim remittance, reconcile and accept claims.
Reconcile and log payment batches daily on the Finance Deposit Spreadsheet.
Research credit balances within work queues, request payor retractions and complete refund paperwork.
Reconcile credit balance withinEpic through adjustment posting.
Review and trend claim rejections in assigned work queues and provide feedback to Management to initiate process work flow changes, provide education to affected areas and remain compliant.
Appeal claim rejections in a timely manner in accordance to carrier specific guidelines.
Reconciles daily work to system generated reports.
Provide phone coverage for Patient Billing Department when necessary.
Responsible for meeting departmental standards and adhering to company policies.
Attend payor meetings for updates when requested.
Other duties as assigned.
Regular and reliable attendance in accordance with department needs and company policies.
Adheres to all HIPAA privacy and security policies and practices.
Other duties as assigned.
Qualifications (Knowledge, skills & Abilities):
Must possess excellent interpersonal skills and have the ability to work well with others in a very busy, close environment as well as independently with minimal supervision.
High level of dependability and accuracy required.
Ability to work independently. Well organized. Goal-directed.
Lifting up to 25lbs., bending and stretching required in storing of supplies and files distribution.
Job requires sitting and working at a computer for extended periods of time.
Excellent written and verbal communication skills.
Knowledge of Excel and Word.
High School Diploma or equivalent (GED)
Continued education in coding and third party reimbursement
Training and Experience:
One year of billing and collection experience in a health care organization.
One year of ICD9-CM and CPT coding experience preferred.

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