Insurance Credit Resolution Specialist

Insurance Credit Resolution Specialist

Requirements

• High School Graduate, Medical Office training certificate or relevant experience
• 3+ years experience in physician revenue cycle / claims management
• Background with posting charges, claim follow up, collections, and payment posting
• Must have experience working with athenahealth’s suite of tools
• Must comply with HIPAA rules and regulations

Responsibilities

• Complete, accurate and timely processing of all assigned insurance related credits
• Review and respond to daily correspondence from physician practices in a timely manner
• Answer incoming inquiries
• Prepare insurance refund checks for mailing
• Process returned checks
• Implement payer specific workflows for void requests, take back requests and insurance refund initiations
• Research and resolve overpaid and denied claims in athenaNet
• Use Salesforce to manage worklists and requests/inquiries from Care Centers
• Successfully process 35+ insurance refunds daily
• Utilize athenaNet software to identify and print appropriate insurance refund letters
• Enter insurance refund check #s into athenaNet for tracking
• In the absence of a payer refund letter, use letter template to make custom refund letters
• Prepare checks to be mailed including matching checks with refund letter, folding, inserting, addressing and sealing envelopes
• Sort checks by payer
• Retrieve and process returned checks accordingly
• Other duties as needed

Preferred Qualifications

No preferred qualifications provided.