Sade Mitchell Email & Phone Number

Remote

• Prepares lock boxes and posts payments from EOBs received the prior day, meeting daily quota outlines with minimal errors.• Runs daily balancing reports and reviews/ corrects discrepancies prior to day close procedures.• Works offset and clearing accounts in a timely manner to eliminate balances in these transition accounts.• Understands and refers to managed care profiles, AWP grids, and other tools necessary to determine proper insurance payment.• Advises Team Leader of any insurance issues as they are identified on EOBs that need immediate attention.• Works up and posts Zero Pay EOBs daily, as included in the lock box for proper distribution to other teams.• Operates electronic posting downloads along with manual postings daily.• Marks appropriate accounts for Review Status.• Makes appropriate system comments related to postings/EOBs remittances.• Maintains a general understanding of HCPCS/ ICD/ CPT coding and carrier requirements

Virginia, United States

•Manages accounts receivables and remittances•Attends to customer database accounts•Addresses discrepancies such as payment issues•Records daily payments including wires, ACH credit transfers, and checks to customer accounts•Handles weekly general ledger reports•Effective attention to detail and a high degree of accuracy•Communicates well with individuals of all backgrounds•Performs data entry, document management, and file creation

Virginia, United States

-Review claims to determine if processing is correct according to automated claims processing system’s methodology for pricing, reimbursement, and cost-sharing.-Consistently meet established productivity, schedule adherence and quality standards-Process adjustments according to TRICARE Policy by making an additional payment, reissue, or statistical adjustment.-Resolve claims edits and suspended claims-Maintains and updates required reference materials to adjudicate claims-Identify and credit refunds to correct claim history. -Request recoupment of payments in accordance with TRICARE Policy and Operational Manual.-Review computer generated and inventory reports to prioritize workflow to ensure claims processing timeline standards are met.