02Requirements
AR callers with sound knowledge of of 3+ Years RCM Experience (Physician Billing).
Working knowledge of healthcare billing software and EHR systems. Preferably Epic, eCW, AMD/NG/Greenway/Centricity
Understanding of Provider Information & Patient Information as it impacts claim resolution.
Knowledge of Clearing House Rejections/Denials and its resolution
Investigate denials and underpayments by thoroughly reviewing EOBs.
Resolve reasons for denial by correcting claim errors and re-submitting appeals as necessary.
Maintain accurate records and ensure follow-up actions are documented clearly.
Knowledge of Appeals Process - Form types/Documents related to Appeals, Online Appeals. Prepare appeals for denied and underpaid claims and ensure the collection of unsettled accounts.
Basic coding knowledge - ICD/CPT, E/M codes, code Series, Modifiers in Physician billing .
