Analyzes and researches denials and follows-up with the appropriate payor, practice, and/or patient to resolve denial. Provides missing or additional information if necessary, to expedite the resolution of the denied claim.
Performs all appeals and denial recovery procedures, which are needed to accurately resolve denied claims.
Processes required adjustments to accounts, including charges credits, payment transfers, policy adjustments, etc. in a timely and accurate manner.
Maintains a thorough knowledge and understanding of all assigned payor contracts and requirements.
Performs research to ensure current policies, applicable coding and insurance guidelines, regulations are being followed.
Prepares accurate and timely reports of trends and problems as they are identified. Communicates such trends to management in a timely manner.
Completes work accurately and timely with appropriate documentation.
Ensures that all activities related to Account Receivable & denials management functions meet department requirements, maximize revenue collection, and achieve leading practice levels of performance.
Consistently meets productivity and quality standards established by management, recommending new approaches for enhancing performance and productivity