* Demonstrates knowledge of editing and submitting claims to insurance clearing house by electronic or paper submission.

* Demonstrates knowledge of when to send a claim to the auditor or coder for corrections.

* Reviews and make corrections to rejected claims and resubmits to payers.

* Open communication on Updates-CPT codes and ICD-10 codes, as needed. Works with Billing Manager to maximize revenue potential based for services and providers.

* Corrects, edits and manages denied claims through work queues, correspondence and emails: May consist of Invalid CPT, Invalid DX, Missing Modifier, Bill another Carrier, Invalid Eligibility, Authorization/Referral, Documentation Required or Other open tasks requiring intervention.

* Enters encounter notes, regarding rejections and follow up activities performed to enable others to review claim history on all encounters.

* Performs account adjustments or write-offs as needed in accordance with the 'Write-Off' policy.

* Handles internal communications with the health centers related to insurance billing and collections.

* Requests medical records from health centers as requested by the contracted insurance plans.

* Corresponds with and assists vendors involved with patient accounts.

* Responsible for reporting any safety related incident in a timely fashion through the Midas/RDE tool; attends all safety related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.

* Maintains confidentiality of all department, patient, and billing matters.

* Completes all company mandatory modules and required job specific training in the specified time frame.

* Stays current and complies with state and federal regulations/statutes and company policies that impact the employees area of responsibility.