Interpret multiple insurance contracts between different healthcare facilities. Upload, revise, update, and modify contracts within EHR for correct estimates on medical services. Collaborate with manager and director in problem solving Prioritize contracts according to effective dates and implementation dates.

Prepare claims to be negotiated from Texas Department of Insurance. Determine eligibility of negotiations via participation of payer networks. Communicate with manager, senior leader, and healthcare providers to settle appeals claims. Develop user friendly spreadsheets the different stages in the mediation and arbitration of healthcare claims.

Facilitate prior authorizations and appeals to secure patient coverage across federal and commercial insuranceAssist provider accounts with overcoming reimbursement challenges; e.g. claim denials, underpayments, appealsVerify financial assistance eligibility and available options for the uninsured and underinsuredCoordinate with regional Case Manager to resolve complex issues and improve customer experience

Process claims in an automated billing system to collect and review all patient insurance information needed to complete the billing, collections, appeal, and/or cash processes . Assisted in educating colleagues on the many features of healthcare insurance, such as deductible, co-insurance, networks, single case agreements, and medical policies, to name a few.

Triage patient.Prepare patient for evaluation from physician and physician assistant.Communicate with providers and other clinical assitants patient care.Inform patient over phone of change in medical treatment.Collaborate with other medical offices for patient treatment.

Medical BillerEnsure medical claims are sent with appropriate information toinsurance entities in a timely manner.Call insurance entities to check on status of claim, reason fordenial and/or when additional information is required.Call patients to explain insurance benefits.•Run reimbursement reports for cost/benefit analysis.Assist administration in creating porformas for future medicalservice lines.Inform management of changes in medical and/or healthcaredevelopment.Educate staff on Medicare protocols and procedures.Clinical AssistantHelp translate written and oral medical instruction for Spanishspeaking patients.Triage patients to assist M.D. with clinical diagnosis andtreatment plan.

Take care of elder man.Ensure medication is taken at prescribed.Spoon feed patient when necessary.Be in call at night.Change patient into clean clothing and diapers.