Analysis Skills, Billing, Communication Skills, Current Procedural Terminology (CPT), Electronic Medical Records, Epic Systems, ICD-10, Insurance, Insurance Claims, Reimbursement, Time Management
Job Responsibilities
- Prepare and submit claims to assigned insurance companies
- Analyze, correct, and resolve claims edits related to billing, charging, and registration errors promptly and accurately to ensure clean claims are submitted in a timely manner.
- Review charges and verify appropriate usage of modifiers, CPT codes and ICD-10 codes prior to billing.
- Research, as necessary, any payer-specific billing and reimbursement rules, including but not limited to Correct Coding Initiative (CCI) edits.
- Resolve clearinghouse rejections and errors.
- Works in Epic EMR to make all claims corrections and resubmits claims when appropriate.
- Monitors claim edit work queues to ensure claims are resolved and submitted within 24 hours.
- Proactively communicates problems or issues in a timely manner for continuous workflow.
- Other duties as assigned.
Education Requirements
- High school diploma or GED
Experience Requirements
- Minimum: One (1) year of experience working with insurance balances in a business office or similar role.
- Preferred: Two (2) years of billing experience working in Epic EMR
License/Certification Requirements