- Call carriers and inquire about payment status on claims according to our in-network contracts.
- Audit discrepancies between billing and payment delays/denials.
- Verify insurance payment accuracy and compliance with contract and customary charges.
- Follow up on unpaid or denied claims and appeal & send medical records as necessary.
- Demonstrate knowledge of third-party payers’ Explanation of Benefits (EOBs) and understand specific time limitations for appeals for all served lines of business.
- Maintain confidentiality of patient information and adhere to HIPAA regulations.