Job Description

• Prepare and submit clean claims to various insurance companies either electronically or by paper. Answer questions from patients, clerical staff and insurance companies regarding claims. Diligently follow up on claims to ensure proper processing. Knowledge of medical billing/collection practices required. Knowledge of computer programs required. Ability to multitask, be well organized and detail oriented.

• None required.

• Minimum 1 year of billing experience, preferably in a pharmacy retail setting.

• High school graduate or equivalent.
• Poses computer system knowledge.
• Knowledge of healthcare patient accounting and healthcare insurance coverage.
• Confidential and good communication skills, both verbal and written.
• Proper use of standard office equipment.

• Ability to sit for extended periods of time. Manual dexterity to use a PC for extended periods of time.

• Timely and accurately submit clean claims to insurance companies.
• Maintain an understanding of third-party billing regulations and contract filing demands.
• Identifies problem accounts with third party payors; investigates, corrects errors and submit claims.
• Responsible for resolving outstanding and unpaid and/or unprocessed claims.
• Review accounts on a regular basis to insure timely filing and payment timeframes are not missed.
• Responsible for resolving outstanding claims by multiple avenues. (ie. phone calls, reviewing third party websites, or sending and receiving correspondence.)
• Utilize A/R reports and EOBs to identify and resolve outstanding third-party claims.
• Carry out job duties in full compliance with ACMC's Corporate Compliance Program and Code of Conduct.
• Perform other duties as assigned by management.

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