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JOB DESCRIPTION OVERVIEW:
This position is responsible working denial reports & correcting/refiling claims based on denial or rejection & eligibility responses. Must be able to note each patients account clearly so that all who need to review accounts will understand what has been done. Must be able to identify FSC according to eligibility website responses. Must be able to work from various source documents. This work is routine and repetitive.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
• Identifies appropriate FSC and insurance company
• Analyzes rejections & denials, identifies probable cause, and makes necessary corrections to refile claims
• Notes all Pt accounts that are worked to insure if review is needed in the future anyone would understand why/how it was refiled.
• Notifies seniors and/or supervisor of system malfunctions.
• Notifies senior and/or supervisor of problems arising from erroneous items, codes, or missing information.
• Performs any and all duties as directed by management.
QUALIFICATIONS / EXPERIENCE:
• High School diploma or equivalent required.
• Six months registration & eligibility experience.
PHYSICAL / ENVIRONMENTAL DEMANDS:
• This job is performed in a well-lighted, modern office environment. Requires constant sitting tolerance and repetitive motion. Organizational skills and neatness are a must.
• This position may require manual dexterity and/or frequent use of the computer, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.
