Clm Resltion Rep III, Hosp/Prv

Performs follow-up activities designed to bring all open account receivables to successful closure. Responsible for an effective claims follow-up to obtain maximum revenue collection. Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims. Resolves complex claims. Acts as a resource for lower level staff.

Responsibilities

Performs follow-up activities designed to bring all open account receivables to successful closure; Responsible for an effective claims follow-up to obtain maximum revenue collection; Researches, corrects, resubmits claims, submits appeals and takes timely and routine action to resolve unpaid claims; Resolves complex claims; Acts as a resource for lower level staff; Bills primary and secondary claims to insurance; Researches and responds to third party correspondence; Explains policies and procedures involving routine and non-routine situations; Coordinates response and resolution to Medicaid and Medicare credit balances; Assists with all audits as needed

Requirements

Associate's degree and 2 years of relevant experience required; Or equivalent combination of education and experience