· Runs deposit reports to make sure daily deposits are balanced and correct· Assist with month end closing · Post insurance payments and denials and patient payments received by mail, fax, and ACH· Identify discrepancies between billed amounts and received payments and take appropriate actions to rectify any discrepancies, including contacting patient or insurance company.· Review insurance payment documents, including Explanation of Benefits (EOBs), remittance advice, and payment checks, to accurately determine payment amounts and reconcile them against billed services.· Collaborate with other operational teams to ensure proper coding and billing practices, helping to prevent payment denials and delays.· Working Accounts Receivables denial management for government payor line of business.· Submitting technical appeals, correcting coding, and submitting corrected claims to payers in a timely manner for Interventional Pain Management services

· Claim scrubbing and submission, bank reconciliation, and the correction and re-submission of problematic claims.· Identify payer adjudication/rejection trends and issues then assist the Encoda technical team to implement new business logic to further automate claim processing workflows.· Payment posting and reconciliation of checks/EFTs received · Assist Encoda's Client Success Manager and RCM Manager with onboarding new clients· Escalate issues to clients for resolution.· Meet all personal and departmental Accounts Receivable goals and metrics.· Participate in training of new software per client request.· Assist with the training, onboarding, and enrollment of new employees · Run daily reports as needed for the client · Monitor and audit the work of others to ensure consistency and accuracy

· Work with payers, internal and external customers, and other contracted clients to obtain efficient and effective collection results for physician and hospital claims· Research claims by utilizing available resources including web portals, Internet, and telephone to determine claim status, resolve payer denials and verify benefits and eligibility· Reviews EOPs/EOBs for posting accuracy · Research and submit appeals and corrected claims to payers in a timely manner

· Receive and process homeowner service requests by phone and email in a timely manner· Handle escalated emergency requests from homeowners by phone and email in a timely manner· Other duties as assigned

· Works directly with payers, internal and external customers, and other contracted clients to obtain efficient and effective collection results.· Coordination of invoice activities leading to timely reimbursement of receivables by using available resources including databases, the Internet, and telephone.· Researches and resolves daily denials that have not passed payer edits and may lead to an appeal of denied services· Prepares corrections and payer appeals using electronic and/or paper processes. Subsequently resolving appeals rejected or returned from the payer.· Utilizes various resources to determine a patient's eligibility, benefits, and health plan confirmation.· Contacts providers, physicians, and patients of service to retrieve appropriate medical documentation to substantiate services provided and engage them in assisting CareCentrix in collecting from the payer.· Reviews EOPs/EOMBs/EOBs for accuracy of patient responsibility.· Verify payer edits and ICD10 codes to ensure correct billing.

· High volume data entry processing professional medical claims as needed on CMS 1500 form as required by Insurance companies for Durable Medical Equipment using appropriate ICD 9 and CPT codes · Contact insurance companies · regarding claim status and denials · Collections of unpaid balances with patient accounts· Obtain Clinical notes, CMN, and prescriptions for claims processing· Worked aged report to show daily revenue gain· Update shipping logs and reports as needed to maintain accurate files and reports· Updated training manual for site staff for a more efficient process for sales and claims· Adhered to CMS claim guidelines in processing claims, appeals, and corrected claims