Prepare, review, and submit insurance claims accurately and within established timeframes.
Work assigned insurance accounts receivable (A/R) to ensure prompt payment and resolution of outstanding balances.
Research, resolve, and appeal claim rejections, denials, unpaid claims, and underpaid claims.
Use payer portals, clearinghouses, telephone communication, and other resources to obtain claim status and secure appropriate reimbursement.
Monitor insurance aging and prioritize accounts to meet established productivity and collection goals.
Identify reimbursement trends, payer policy changes, and recurring denial patterns, and communicate findings to leadership.
Maintain accurate and timely documentation of account activity, claim follow-up, appeals, and payer communication.
Maintain current knowledge of payer guidelines, coverage policies, reimbursement methodologies, and applicable regulatory requirements.
Collaborate with team members and other departments to resolve billing issues and improve claim reimbursement outcomes.
Support departmental goals by maintaining productivity, accuracy, and timely follow-up on assigned accounts.
Previous experience in medical billing, insurance follow-up, claims processing, denials management, or healthcare accounts receivable.
Strong understanding of insurance claims, denials, appeals, reimbursement, and accounts receivable processes.
Experience using payer portals, clearinghouses, and electronic billing or practice management systems.
Knowledge of medical terminology and insurance billing requirements.
Proficiency with computer software and Microsoft Office applications.
Excellent verbal and written communication skills.
Strong analytical, research, and problem-solving abilities.
Excellent organizational and time management skills.
High level of accuracy and attention to detail.
Ability to manage assigned accounts independently while contributing to a collaborative team environment.
Schedule
Monday through Friday, 8:00 AM to 5:00 PM, no nights or weekends!
Personnel Resources is an Equal Opportunity Employer.
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