Job Detail

SUMMARY:

Coding & Charging Capture Integrity Analyst frequently interact with patients, doctors, and insurance companies, so they need some experience with customer service tasks and the ability to maintain patient records and confidentiality and ensure that patient information is complete and up to date.

RESPONSIBILITIES AND DUTIES:

• Obtain and verify insurance eligibility for services provided and document complete information in system
• Determine patient’s financial responsibilities as stated by insurance
• Configure coordination of benefits information
• Ensure assignment of benefits are obtained and on file for Medicare claims if necessary

Resolve billing queries, which can include:

• Bad addresses (call patient)
• Missing authorizations (request from office)
• Retrieval of Missing OP and or Consult Notes (retrieving from Citrix)
• Other miscellaneous query reasons
• Sort correspondence/EOBs and email to 3rd party billing company
• Retrieval of EOBs and faxes
• Request correct CPT and ICD-10 codes from providers
• Processing of payment batches to 3rd party billing company.

• Document all pertinent communication with patients, physicians, insurance company as it may relate to collection procedures
• Identify and coordinate patient resources as it pertains to reimbursement, such as copay cards, third party assistance programs, and manufacturer assistance programs
• Handle inbound calls from patients, physician offices, and/or insurance companies * Resolve claim rejections for eligibility, coverage, and other issues

• Other duties as assigned.

EDUCATION & EXPERIENCE REQUIREMENTS:

• Minimum of 6 months of insurance verification experience (healthcare) preferred SKILLS & ABILITIES

REQUIREMENTS:

• Strong customer service skills
• Medical billing experience preferred
• Experience with payors preferred
• Experience with prior authorizations preferred

PHYSICAL REQUIREMENTS:

• Body Positions: Sitting and standing for prolonged periods.
• Body Movements: Arm and hand dexterity.
• Body Senses: Must have command of close and distant sight, color perception and hearing.
• Strength: Ability to lift and move up to 25 pounds.