Duties were as follows: monitor charge capture software daily and remove claims from billing system that need to be addressed by the different hospital’s revenue departments, follow-up on all coding issues, adjustment to patient transaction systems for accuracy and re-bill the claims after resolution through the Hospital’s billing software (SSI).Review insurance payments from contracted insurance companies to compare all payments to contracted rates. Interact with the contracted insurance companies to resolve and follow-up on unpaid, incorrect payment recoveries. Review all insurance payments, adjustments and assist Accounts receivables on all discrepancies and postings

Duties were providing clear and accurate responses to members, providers and internal co-worker inquiries on benefits, claims processing and adjustments.Find resolutions to member/provider complaints in a speedy and effective manner.Apply quality decision-making by accurate analysis of medical claims and claim processing to minimize risks.