Abby Brogdon Email & Phone Number

Claims submission : Prepares and submits clean claims to various insurance companies either electronically or by paper. Performs claims follow up tasks including online research as well as phone calls to payers to resolve billing issues. Works directly with insurance company and healthcare providers to get the claims paid.Billing Process: Verifies eligibility for patient claims. Posts remit electronically and manually from Website/portal/clearing house. Manages the facility's account receivable reports. Performs rebilling and crossover tasks to assure payment of all open claims.Reporting and Tracking: Creates and maintains a weekly report on billing for clients. Manually enters data into software. Maintains and addresses follow up items on client issue trackers.Compliance: Maintains strictest confidentiality, adheres to all HIPPA guidelines/regulations. Responsible for password protecting all documents sent outside the limits of the company. Conducts self in accordance with HIPPA's employee manual.

•Billing Process - Overseeing the billing process, from charge entry to claim submission and payment posting.•Insurance Verification - Ensuring that patients insurance information is accurate and up to date.•Claim Submission - Reconcile all charges and data entered into the system assuring 100% accuracy; assure correct provider, facility, medical service and coding are billed. Properly approving coding and diagnoses for charge slips.•Compliance - Ensuring that all billing activities comply with relevant laws and regulations, including HIPAA. Complying with billing and coding guidelines.•Reporting and Tracking - Sending reports to OPS and management in regard to the provider’s payroll based on patient’s financial class. Along with tracking providers credentialing statuses.•Payer Rejections - Identifying and removing claim detail that do not meet the criteria for reimbursement, ensuring compliance and accurate revenue capture.

•Introducing and learning a new billing system for our company.•Centralization of Billing Functions - Combine billing tasks across multiple departments or locations into a single unit. Ensuring consistency and efficiency in the billing process.•Reporting and Data - Documenting accounts that require write offs, unpaid patient and insurance balances, and refunds. Reporting trending denials and billing discrepancies. Tracking accounts to guarantee accurate billing.•Compliance - Helping ensure that our company complies with the latest regulations and standards, reducing the risk of legal issues and fines.•Accuracy - Implement standardized procedures and use advanced software to reduce errors in billing.

•Service Quality - Advocates for all patients with advanced soft skills to resolve billing disputes, claim processing errors, clinical complaints, patient collections, and financial assistance. Works with patients and providers to resolve account challenges and communicate appropriate next steps for trouble shooting.•Billing and Coding - Reviews EOBS/ERA payment posting and adjustments to correct patient balances discrepancies and to identify issues such as denials, and over or underpayments. Uses medical coding resources to resolve coding disputes. Accurately updating insurance information for patients as requested. •Payments and Collections - Reviewing billing transactions for accuracy and to help resolve payment posting challenges on patients accounts. Maintain insurance information for cost estimates per contractual rate.•Call Center Development - Handles Revenue Cycle Department Interactions via phone. Identifies potential revenue cycle challenges and escalates to departmental/leadership if necessary. Answers patients questions on information regarding clinicians and our location/sites. Updates Primary Care Physician change request from patients.