Bianca Lewis Email & Phone Number

Houston, Tx, Us

Houston, Texas, United States

• Responsible for managing and maintaining a workload of approximately seventy (70) accounts or higher per day to ensure claim(s) resolution.• Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCD’s) for claim resolution.• Review and attach appropriate documentation to resolve denied claims and submit appeals.• Call payers to determine the true reason for denial and inquire on what corrections need to be made.• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or payer portals.• Review underpayments and overpayments, work with management to prepare spreadsheet and summarize findings; escalate as appropriate.• Prepare and submit denied claims targeted project files to payers, track reprocessing of project files.• Problem solving claims with trends and contract violations and report findings to the Manager and Director.• Contact insurers regarding recoupment payments, double debits, overpaid accounts, and missing checks; initiate dispute process as needed.• Update insurance information in the system as necessary, initiate and support primary, secondary and tertiary billing.• Per form other duties assigned by Revenue Cycle Manger.

United States

Outbound SME (Subject Matter Expert)

United States

United States