01Overview
Job Description:
Good knowledge of medical coding and billing systems, medical terminologies, regulatory requirements, auditing concepts, and principlesInvestigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating softwareObtain vehicle information from the DMVFollow HIPAA policy on each and every callAbided by the laws and regulations associate under HIPAA and patient confidentialityReceive recognition for creating a workflow and database for all incoming subpoenasAssist in training new CSA's on job responsibilities, which increase office productivityEnsure compliance with company regulations and Medicaid requirementsCoordinate Medicare, Medicaid, and secondary insurance coverageGather and compile evidence to support contest claims in litigationReview automobile titles, completing transfers and owner retention DMV documents with customersConduct detail bill reviews to implement sound litigation management and expense controlIdentify claims for potential fraud and abuse and process expedited appeals and organizational determinationsDevise creative and cost-effective incentive and morale-boosting programs that increase CSA satisfaction and productivityExecute effective and efficient claim dispute resolutions in regard to provider and facility appealsAssist veterans and their dependents in determining eligibility for VA benefits via phone contact and personal interview .