Billing And Insurance Representative
CurrentPatient Phone CallsI help patients with their account questions.I take payments using InstaMed.I respond to basket messages from patients.Workman's Comp Referral work queue: I verify that the claim for the affected body part, claim number, date of injury, adjuster name, phone number, and email address is open and accepted. Then, with the insurance department's approval, I send it to the phone room. The phone room will then forward the information to the appropriate provider.Route worker's comp paperwork to the treating provider. When the provider has filled out and signed the paperwork, I forward it to the work comp carrier and enter the paperwork charges.Registration Work QueuesI correct registration errors.Claim edit - Registration Errors.Claim edit - No Rules WQ Missing ICNCharge review Southern Oregon Orthopedics Clinic review.Grants Pass Orthopedics Clinic review.Follow-up Work QueuesMedicare FC Denial and No ResponseMedicaid FC Denial and No ResponseCommercial FC Denial and No ResponseWorkers Comp Denials and No ResponseDME Denial and No Response30-Day Deferral - No filtersFilter by response/denial codes and work claims accordingly21 - Denied liability of no-fault carrier22 - Another payer per COB may cover this care26 - Expenses incurred before coverage27 - Expenses incurred after coverage terminated109 - Claim/service not covered by this payer/contractor. I send the claim/service to the correct payer/contractor.227 - Information requested from the patient/insured/responsible party was not provided or needed to be more complete.252 - An attachment/other documentation is required to adjudicate this claim/serviceI work on other response/denial codes deemed appropriate by the manager/supervisor/lead.SNF patient X-ray charge denials. I correct the claim with a modifier and enter the charge to the SNF.Paper ClaimsI print claims daily, attach chart notes and operative reports, and mail other correspondence needed.
