Full-Time Biller+ Claims Specialist

Biller+ Claims Specialist

Under the supervision of the CODER/BILLER+ Program Manager, the Biller+ AR Manager is responsible for complete, accurate, and timely processing of all designated claims.

Review and respond to daily correspondence from physician practices, answering incoming telephone calls, and providing information as requested.

Assist in Coder/Biller+ go-live training and communicate closely with providers and practice staff.

Key Responsibilities:

• HOLD and Denial Management: Investigate denial sources, resolve and appeal HOLDs/Denials (may involve contacting payer representatives), adjust claims (resubmission, appeals).
• CODER/BILLER+ Training: Assist in CODER/BILLER+ trainings.
• Research and Answer: Research and answer BILLER+ claim HOLD questions; deliver instructions to providers and practice staff.
• Case Management: Manage Salesforce cases, Route claims, Manage all Biller+ cases, Manage all Coder+ cases
• Escalation Point: Serve as primary escalation point for coding issues, resolve with vendor, relay resolutions.
• Monitoring and Compliance: Monitor and respond to emails timely, Follow guidelines and legal requirements.
• Collaboration and Program Success: Collaborate with Success Management on Check-in meetings, provide HOLDs breakdown and aging reports, identify trends and solicit feedback from Care Centers.
• Training and Support: Provide additional training sessions as requested, clean-up projects for escalated care centers, review current HOLDs in practice worklist.

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