Should be able to post ERAs and Manual posting, patient-cash, check payments.
Should have strong understanding of medical billing terms, such as co-pays, coinsurances, deductibles allowable amount, contractual adjustments, out-of network and in-network processing, retractions/recoupments and Zero claims.
Should be able to identify line item denials for non-covered services, inclusive services, credentialing, medical necessity, non-par, no-auth denials, COB Denials and associated denial reason codes.
Medicare claims processing-sequestration, interest payment, reporting codes, Modifiers
Should be able to understand Payer specific guidelines, process secondary and Tertiary claims and patient statements.
Reconciliation and balancing the payment batches.
Operational Duties:
Comply to daily productivity and Accuracy standards.
Submit daily production reports to team lead.
Stay in constant communication with team lead /operations manager
Professional & behavior is expected
Receive feedback from QA on errors and follow updated protocol.
Additional Comments
Preferably having experience with NG/eCW practice manager
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