The Role
The role involves tracking claims, communicating with payers, managing denials, processing appeals, handling patient collections, and maintaining accurate records.
Summary Generated by Built In
Roles & Responsibilities
- Claim Tracking: Monitor aging reports and work queues to identify unpaid invoices or claims past 30, 60, or 90 days.
- Payer Communication: Contact insurance companies or clients via phone, email, and online portals to verify claim status and reasons for payment delays.
- Denial Management: Investigate rejected claims, identify root causes (e.g., coding errors, missing information), and resubmit corrected claims.
- Appeals Processing: Prepare and submit technical appeals for denied or underpaid claims based on specific payer guidelines.
- Patient Collections: When insurance does not cover the full balance, reach out to patients to explain their responsibility and establish payment plans.
- Detailed Documentation: Maintain accurate records of all interactions, including contact names, dates, and account notes for future audits
Skills Required
- Experience in medical billing or accounts receivable
- Knowledge of insurance claims processing
- Strong communication skills
- Detail-oriented and organized
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The Company
What We Do
GetixHealth provides hospitals, clinics, university medical centers, and other healthcare facilities across the United States with comprehensive revenue cycle management (RCM) services. Our services are customized to the needs of our client and can either include all facets of the front and back office revenue cycle or a mixture of these services, including but not limited to: medical coding and billing, claims management, insurance eligibility services, medicaid/medicare specialized services, and self pay and bad debt collections.
