Job Roles :
Ensures efficient processing of denials and appeals. Meets cash collection goals by reviewing , analyzing , completing , and submitting appropriate documentation based on payer requirements.
Conducts research and provides updates and current status of collection efforts using the appropriate data management systems.
Performs extensive follow - up and collections for third parties , resolving issues that are adversely impacting claims payment.
Communicates information and ideas to make system - wide process improvements. Updates data regarding changes and modifications in plan benefits and other contract information relevant to billing or claims follow up and collection processes.
Completes special projects as assigned.
Serves as a communication link to various departments , external payers or vendors by developing positive relationships with managed care organizations and outside agencies , and clinical areas within the organization.
Performs liaison services to both internal and external customers providing assistance in billing , collections and claims resolution.
Reviews and responds to correspondence and inquiries generated by third party payers. Provides medical record copies and other pertinent information to the appropriate sources throughout the collection process.
Assists with education of internal staff and external customers to bring about the timely , accurate , and cost effective Adjudication of all claims.