Responsibilities:

• Review and resolution of rejected claims in the 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 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.

Must Have Skills/Qualifications

• 3+ Years clearinghouse rejections
• Very strong grasp of coverage, dependence, errors in portals, updating patient/dependent information, invalid zip codes, wrong demographic information, claim logic problem (billing and insurance verification).

Schedule Shift:

Mon-Fri 8am-4:30pm (3 days remote, 2 onsite)