Clearway Pain Solutions

• Supports the complete and timely collection of revenue for assigned groups by performing accurate coding and entry of patient and charge information into the billing system. • Tracks all high dollar claims from charge entry to payment and resolves complex carrier issues. • Actively follows up on outstanding complex claims/or charges. • Reviews and resolves complex issues that result in payer denials, including appeals, coding corrections, medically necessity rules and other related functions. • Assists the auditor in reviewing notes for medical necessity. • Works with the authorization department to resolve authorization issues with complex procedures. • Runs and maintains tracking logs to track complex high dollar procedures and report the results to the billing department management team. • Contacts the various Provider Service Representatives to resolve repetitive payment issues. • Acts as a resource for the Billing Staff for complex issues. • Analyzes and resolves billing issues, keeping A/R to no more than 10% over 60 days. • Processes daily correspondence, claim status, handles denials, appeals, and re-bills. • Answers billing questions and inquiries from patients and internal staff. • Updates patient files with address changes, contact information changes, etc., as needed. • Reviews all policy changes on a regular basis and informs supervisor and charge entry specialist of such changes. • Efficiently navigates assigned insurance companies' proprietary websites to find policies, research payments, etc. • Keeps supervisor apprised of matters regarding accounts receivable. • Responds to requests from the billing company in a timely fashion. • Researches denials and submits correct claims/medical documentation. • Reviews and manages claims within the work dashboard hold buckets for resolution. • Creates, maintains, and updates reports, as directed. • Exercises confidentiality in all areas, abiding by HIPAA rules and regulations. • Helps train new revenue cycle staff. • Collects and reviews end of day reports. • Checks work e-mail on a regular basis throughout the workday. • Participates in and completes all required trainings and in-services. • Performs other duties as assigned.

• Supports complete and timely collection of revenue for assigned groups by performing accurate coding and entry of patient and charge information into the billing system. • Tracks all high dollar claims from charge entry to payment and resolves complex carrier issues. • Actively follows up on outstanding complex claims/or charges. • Reviews and resolves complex issues that result in payer denials, including appeals, coding corrections, medically necessity rules and other related functions. • Assists the auditor in reviewing notes for medical necessity. • Works with the authorization department to resolve authorization issues with complex procedures. • Runs and maintains tracking logs to track complex high dollar procedures and reports the results to the billing department management team. • Contacts various Provider Service Representatives to resolve repetitive payment issues. • Acts as a resource for the Billing Staff for complex issues. • Analyzes and resolves billing issues, keeping A/R to no more than 10% over 60 days. • Processes daily correspondence, claim status, handles denials, appeals and re-bills. • Answers billing questions and inquiries from patients and internal staff. • Updates patient files with address changes, contact information changes, etc., as needed. • Reviews all policy changes on a regular basis and informs supervisor and charge entry specialist of such changes. • Efficiently navigates assigned insurance companies' proprietary websites to find policies, research payments, etc. • Keeps supervisor apprised of matters regarding accounts receivable. • Responds to requests from billing company in a timely fashion. • Researches denials and submits correct claims/medical documentation. • Reviews and manages claims within the work dashboard hold buckets for resolution. • Creates, maintains and updates reports, as directed. • Exercises confidentiality in all areas, abiding by HIPAA rules and regulations. • Helps train new revenue cycle staff. • Collects and reviews end of day reports. • Checks work e-mail on a regular basis throughout the workday. • Participates in and completes all required trainings and in-services. • Performs other duties as assigned.