Review billing charges entered by physicians for accuracy prior to claim submission. Knowledge of ICD-10 codes and payer guidelines. Interpretation of insurance verification with ability to explain and answer questions regarding plan details to patients. Create and manage spreadsheets identifying patient responsibilities based on deductible, coinsurance, and co-payment amounts. Obtain authorizations for in-office procedures. Create OB contracts with payment plans (commercial/self-pay). Conduct patient outreach to confirm insurance coverage and advise of concerns regarding coverage. Update patient accounts to reflect Medicaid eligibility as well as correct payer order. Connect families and individuals with financial or food insecurities to area agencies for continued care and support. General office duties including incoming / outgoing calls, faxing, assisting front desk with patient registration and scheduling, and payment collections.

Assist Medicare Advantage members with health plan related questions and or concerns. Manage escalated concerns effectively by communicating to members the results of their appeals or denials in addition to next steps available. Locate in-network providers or facilities for members to receive covered services and schedule appointments as per the members request. Troubleshoot claims and or issues with pharmacy benefits or prescription coverage. Arrange transportation to and from medical appointments. Contact provider offices, on behalf of the member, to obtain clarification on billing concerns and assist members with processing premium payments.

Schedule and register patients for appointments by reviewing and entering their demographic and insurance information into the system. Responsible for collection of co-payments/balances/co-insurances and ensure that the patient's check-in/check-out process is as smooth and enjoyable as possible creating meaningful relationships. Handle deliveries of incoming office supplies, devices ordered for patients, snacks for distribution in waiting area in addition to the processing of "Release of Information" requests on behalf of patients and/or their providers. Review all incoming messages of concerns or appointment requests through the patient portal and disperse them as needed to staff while also processing incoming referrals. Handle general office duties such as answering phones, faxing, copying, emailing, and end-of-day individual financial batch close-out when required. Train new front desk hires. Completed Emerging Leaders leadership class within organization.