Responsibilities:

• Review and resolution of rejected claims in the Waystar clearinghouse portal.
• Request Service tickets to correct payer claim formatting or claim data points.
• Audit of Offshore Team and calibrate Offshore Quality Auditors.
• Review of NextGen tasks assigned to Region Billing task group.
• Review of NextGen weekly and monthly NextGen claim oversight reports.
• Coordinate with Provider Enrollment Team for provider claim data and effective dates and
  update provider billing data on claims.
• Review returned paper claims for correct mailing address and request payer code updates as
  needed.
• Research claims formatting issues and submit service requests to Pediatrix to update claims
  formatting.
• Respond to customer service issues sent by the Patient Financial Services team.
• Make additional efforts on high balance accounts by make calls to any or in combination to any
  of the following: patient, hospital, payer.