House + Home Loans

• Contact insurance carriers on a daily basis to follow up on/collect past due amounts on outstanding medical claims regarding denials or benefit changes. • Maintain an accurate, up to date aging of assigned accounts including AR analysis and follow up. • Keep educated on billing and medical policies for all payers. • Have a working knowledge of In and Out of Network reimbursement processes/methodologies. • Create and follow up on appeals needed to protest denials or incorrect payments. • Review complex denials/tasks assigned by the payment posting team and resolve accordingly including reviewing refund requests, disputes and appeal as necessary. • Work across all RCM departments to get issues related to claims payment resolved. • Uphold and ensure compliance and attention to all company policies and procedures as well as the overall mission and values of the organization. • Work with AR Supervisor to review/resolve open accounts as assigned. • Perform other duties as assigned.

• Conduct coding audits • Communicate results and recommendations • Provide training and education to providers and ancillary staff • Support the implementation of changes to coding standards