Job Description

Job holder is responsible for the identification, mitigation, and prevention of denials along with preparing reports on clinical disputes based on the criteria documented. Assists with day-to-day revenue cycle denial operations and supports process improvement initiatives for coding, billing, and collections activities associated with denial prevention.

Responsibilities

• Monitors compliance with rules and contractual terms and agreement with insurance companies and DOH guidelines.
• Ensures compliance with the facility pricing structure and the rules for different patient categories (including self-payer) with implementation.
• Prepares submissions for all patient invoices (claims) electronically.
• Maintains and reports incorrect charges and charges not captured to Team Billing Lead or Billing Manager. Bills all secondary claims processed on a daily basis that are produced by the billing system.
• E...