Account Specialist
CurrentFollows up on claim rejections and denials to ensure appropriate reimbursement for our clients; Process assigned AR work lists provided by the manager in a timely manner; Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution; Identify and resolve denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizations; Recommend accounts to be written off on Adjustment Request;… Show more Follows up on claim rejections and denials to ensure appropriate reimbursement for our clients; Process assigned AR work lists provided by the manager in a timely manner; Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution; Identify and resolve denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizations; Recommend accounts to be written off on Adjustment Request; Properly notates patient accounts; Review each piece of correspondence to determine specific problems; Research patient accounts; Reviews accounts and to determine appropriate follow-up actions (adjustments, letters, phone insurance, etc.); Processes and follows up on appeals; Files appeals on claim denials; Scan correspondence and index to the proper account; Inbound/outbound calls required for follow up on accounts; Respond to insurance company claim inquiries; Communicates with insurance companies for status on outstanding claims; Performs special projects and other duties as assigned Show less
