Employer: Surgery Partners
GENERAL SUMMARY OF DUTIES:
Responsibilities include:
- Reviewing ID cards for correct payer billing;
- Attach the correct contract to the claim for appropriate billing.
- Review claims for accuracy and completeness prior to submitting to insurance carrier
- Obtain any missing information in order to submit clean claims
- Prepares, reviews and transmits claims using billing and clearinghouse software
- Reviews claim rejections and make necessary corrections for payer acceptance
ESSENTIAL FUNCTIONS:
- Interact with Facilities and Business Office Personnel in a professional manner to collect data needed to successful bill out claims. Showing respect for co-workers, patients and customers at all times.
- Reviewing ID cards for correct payer billing;
- Attach the correct contract to the claim for appropriate billing.
- Review claims for accuracy and completeness prior to submitting to insurance carrier
- Obtain ay missing information in order to submit clean claims
- Prepares, reviews and transmits claims using billing and clearinghouse software
- Reviews claim rejections and make necessary corrections for payer acceptance
- Payer Portal use to enter claims or uploads as needed
- Ensure that all data needed to pay claim has been delivered to the payer (invoicing, medical records)
- Using Denial Management tools, resolves any denial promptly to ensure prompt payment
- Any additional duties to ensure claims are submitted to the correct payer with the payer data needed to ensure timely payment of claims