This company is an equal opportunity employer and makes employment decisions without regard to race, color, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. This company is a VEVRAA Federal Contractor.

Position Goal: Maintains overall understanding of assigned payor to include what is covered versus non-covered Serves as a liaison between clinic and assigned payor.

• Organizes clinic claims for electronic or hard copy mail and forwards to appropriate third party payors.
• Reviews claims to make sure that the payor specific billing requirements are met, follows up on billing, determines and applies appropriate adjustments, answers questions and updates accounts as necessary.
• Manage assigned Payor hold/Manager hold buckets.
• Manages Accounts Receivable to ensure timely and maximum reimbursement.
• Meet the daily requirements of communicated claims productivity.
• Assists patients with questions/payments on their accounts.
• Appropriately appeal insurance claims in a timely manner.
• Research and write up refunds.
• Performs other duties as assigned by Management.

Minimum Qualifications: Minimum of two years insurance claims/related experience.  Two years experience of CPT and ICD-10 terminology.
Preferred Qualifications:  Coding certification preferred.  Familiar with standard concepts, practices and procedures of this particular field. 
Education: High School Diploma or equivalent required.
Special Qualifications: Must be able to work independently.