1. I Reviews chart documentation/EMR to ensure the patient meets medical criteria for services/procedures requested.
2. Prioritize incoming authorization requests according to urgency.
3. I do perform telephonic/fax/online review of procedures to insurance carriers

4. I do Maintain individual payer files to include up-to-date requirements needed to successfully obtain authorizations.

5.  I do Initiate appeals for denied authorizations including the arrangement of Peer to Peer reviews.

6.  i do Response to clinic questions regarding payer medical policy guidelines.

7.  I do Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order.

8.  I od Update Client System with Payor decision accordingly.

Receive, process, and apply all customer payments with a high level of accuracy.
Research and resolve payment discrepancies or account adjustments as needed.
Generate and review AR Aging reports to ensure collections compliance.
Modify invoices and billing statements
Strong customer service skills and relationship building
Strong experience with Microsoft Office Suite
Ability to work in a high-volume work environment
Problem analysis and problem-solving skills.
Payments, collections, accounts balancing,
Insurance Eligibility verification, and HIPAA requirements.
Applied all payments received by insurance, patients, and credit agencies to accounts
Post explanation of benefits/remittance advice payments manually.
Work Aging Reports. Research any unpaid claims and any incorrectly or partially paid claims.
Assist patients with billing questions and payment arrangements as necessary.
New Patient Account Management
Monthly processing of patient statements
Follow up on Insurance and receivables aging
Evaluation of Third party claims
Patient and coordination of benefits
Monthly All clients collections reports
Client billing summaries.