Optim Health System

• Protects the financial standing of Optim Health by performing functions related to the billing, coding verification, collection, payment, and customer service for all payer and patient accounts. • Under general supervision, is responsible for processing insurance and billing insurance in a timely manner. • Reviews assigned electronic claims and submission reports. • Resolves and resubmits rejected claims appropriately as necessary. • Works closely with Medical Records, Coding, Revenue Integrity, Patient Access, and Patient Financial Services departments to resolve outstanding claim errors by obtaining necessary information for accurate billing. • Processes daily error logs, stalled reports, aging claims, and any ah-hoc reports. • Addresses claim issues from insurance companies requesting additional information and/or checking status of billings. • Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. • Initiates next billing, assign appropriate follow-up and/or collection step(s), this is not limited to calling patients, insurers or employers, as appropriate. • Sends initial or secondary bills to Insurance payers. • Documents billing, follow-up and/or assign collection step(s) that are taken and all measures to resolve assigned accounts, including escalation to Supervisor/Manager if necessary. • Processes administrative and Medical appeals, refunds, reinstatements and rejections of insurance claims with the oversight of the Supervisor and/or Manager.