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Job description
Claims ExaminerExamines denied and underpaid claims to determine reasons for discrepancies. Provides payers with specific reasons for the suspected underpayments and analyzes denial reasons given by payers. Works with management to identify, trend and address root causes of denials; helps pinpoint strategies for reducing AR. Maintains a thorough knowledge and understanding of federal and state regulations, as well as specific payer requirements and explanation of benefits, in order to identify and report billing compliance issues and payer discrepancies. Updates and maintains accurate files on each payer including contact names, addresses, phone numbers, web sites and other pertinent information thoroughly documents all interactions with payers. Effectively handles all communication, including telephone and email from payers and departments within Revenue Cycle. Participates in continuous quality improvement efforts on an ongoing basis, establishing goals with manager and tracking progress (attends huddles). Demonstrates initiative and resourcefulness by making recommendation and communicating trends and issues to management. Crossed trained in other areas within Patient Accounts. Begins HBI Revenue Cycle classes. Understands and maintains compliance with HIPAA guidelines when handling patient information. Performs other duties as assigned.
Worksite address
laurinburg, NC, 28352, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.