Customer Service
3 weeks ago
Contacts payers for medical claims status, followup denials, or partial payments
- Obtains payer requirements for timely adjudication of claims
- Files claims with appropriate documentation attached
- Pursues, maintains, and communicates medical coverage/guideline changes/updates
- Processes all incoming and outgoing correspondence as assigned
- Verifies, adjusts, and updates Accounts Receivable (A/R) according to correspondence received from insurance company
- Helps facilitate interoffice communication on error and denial trends
- Initiates the review/appeals process on disputed claims
- Researches credit balances and initiates refunds as required
- Documents all activity in customer's computer account
- Answers Accounts Receivable phone inquiries
- Works assigned RBCO reports
- Available to assist other PACs with questions or collection needs
- Acts as liaison between staff and management
CC
**Requirements**:
- High School Diploma or General Education Degree (GED) required
- Past performance shows solid evidence of insurance qualifications and guidelines
- Knowledge of telephone etiquette and adequate oral and written communication skills
- Shows effective multitasking skills
- Positive and cooperative attitude in working and communicating with individuals at all levels of the organization
- Knowledge of medical field preferred
CC
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