Billing Collection Specialist
- Enters information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information.
- Ensures claim information is complete and accurate.
- Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form.
- Answers patient questions on patient responsible portions, copays, deductibles, write-off’s, etc.
- Follows up with insurance companies on unpaid or rejected claims.
- Resolves claims issues and re-submits claims when required.
- Prepares appeal letters to insurance companies in disagreement with claim denial.
- Collects necessary information to accompany appeal.
- Ensures patient statements are mailed on a regular basis.
- Works with patients to establish a payment plan for past due accounts in accordance with practice policies.
- For patients with coverage by more than one insurer, prepares and submits secondary claims upon processing by primary insurer.
- Has adequate understanding of managed care authorizations and limitations to coverage.
- May have to verify patient benefits eligibility and coverage.
- Knowledgeable on insurance and reimbursement process.
- Basic understanding of medical ICD 9/10 codes and CPT medical billing codes.
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