- Follow up on submitted insurance claims to ensure correct and timely payment.
- Monitor and manage assigned payer accounts to minimize delinquent balances.
- Investigate denials, underpayments, and unpaid balances to determine resolution paths.
- Work directly with payers to correct issues and secure reimbursement.
- Distinguish between claims billed correctly versus those requiring correction or rebilling.
- Collaborate with internal billing, pharmacy, and operations teams to resolve claim issues.
- Respond to customer and internal inquiries related to claim status.
- Stay current on billing regulations, coding guidelines, and payer policy updates.
- Utilize clearinghouses and billing systems to support effective collections workflows.
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