Sr Assoc, Physician Billing

Reviews and verifies all demographic and insurance information utilizing available technologies, payer websites, or by phone contact with third party payers or guarantors. Collaborates with management and peers to ensure all required information is obtained for resolution of charge edits, claim edits, denials, and appeals in a timely manner, while adhering to government/payer regulation and department policy/procedures. Prepares and submits accurate insurance claims and appeals to payer within required timeframes and in accordance with government/payer regulations and requirements. Resolves outstanding charges and claims responding timely and accurately for resolution of outstanding balance while adhering to department policies/procedures. Accepts, rejects, and reconciles claim runs on timely basis and processes payer response reports in an effective and timely manner. Reviews and processes guarantor overpayments per department policies and procedures. Responds to inquiries received via telephone and other correspondence from patients/guarantors, insurance carriers, departments/foundations as needed. Assist with the training of newly hired staff in process and system navigation.