Responsibilities:

Reviews and resolves billing edits and claim denials from payors by researching payor policies, reviewing billing records, and understanding EPIC workflows Submits corrected claim(s)/appeals in accordance with payor policies and billing regulations to maximize reimbursement and efficiently lower A/R Maintain account notes detailing progress on collecting open aged receivables &/or disputes Prepares appeal letters to insurance carrier with necessary information to accompany appeal Collaborates with team on additional Workflows and/or Job Aids Completes all assigned work in a timely manner based on internal, client and/or payer standards Identify root causes of denials to Manager in order to enhance the system, work with Contracting on payor issues, or communicate departmental workflow issues to the Engagement

Manager Communicates with manager any changes, updates, or new policies identified through day-to-day functions

Education and skills required: High school diploma required, some college preferred At least two (2) years experience in a physician billing setting Experience in the EPIC PB billing system is required. Independent, detail oriented individual with strong analytical skills. Must have a good verbal and written communication skills. Must have knowledge of health insurance reimbursement and billing requirements. Must be familiar with HIPPA guidelines. Must be able to apply policy and procedure to make independent decisions to secure reimbursement