• Initiates contact insurance companies (phone, fax, or web portals) to verify benefits, eligibility, and authorization requirements • Submits and follows up on pre-certification, authorization, and retro-authorization requests until determination is received • Obtains and provides clinical information by collaborating with care management teams or accessing patient medical records • Completes detailed electronic documentation to ensure accurate benefit verification and clean claim processing • Identifies and corrects inaccurate insurance plan codes within the hospital system • Maintains HIPAA compliance and documents all actions clearly while communicating professionally with patients, team members, and stakeholders • Other assigned duties and tasks.

• Work all payers in a single financial class • Identify and resolve denials through research, appeal, correcting and rebilling claims • Verify and update insurance coverage as applicable • Apply entry to intermediate level research methodologies consistent with SBO department complexity matrix • Work to identify and resolve no response claims including but not limited to claims not received, unbilled claims, and unprocessed claims • Submit corrected claims • Generate and release complex itemized statements and medical records • Attend applicable meetings including payer meetings and educational opportunities as appropriate

• Work complex to intermediate payer denials requiring entry level understanding of payer reimbursement methodologies and billing guidelines • Identify and resolve denials through research, appeal, correcting and rebilling claims • Verify and update insurance coverage using EHR tools, payer websites, or phone calls • Process late charges using the late charge functionality • Generate and release complex itemized statements and medical records. • Identify payer plan issues and work with SBO leadership to address them • Support Lean principles of continuous improvement with energy and enthusiasm • Deliver customer service and/or patient care in a manner promoting goodwill, timeliness, efficiency, and accuracy

• Answer inbound and outbound patient calls professionally • Schedule and coordinate patient appointments and follow-up visits • Verify insurance eligibility and benefits • Assist with prior authorizations and referral coordination • Follow up with patients regarding appointments, treatment plans, and outstanding requirements • Communicate with insurance companies regarding eligibility, coverage, and authorizations • Maintain accurate patient records and documentation within the EMR • Coordinate communication between providers, patients, and external healthcare partners • Ensure HIPAA compliance and patient confidentiality at all times • Deliver exceptional customer service and support patient retention