SPECIAL ACCOUNTS REPRESENTATIVE III
On-siteLakeland, Florida, United States
Job Summary
Follow up on open claims, review submissions for completeness and compliance, and resolve disputes regarding third-party denials or underpayments. Contest charges with carriers by accessing online services and documenting all actions within the system. Complete appeals according to payer-specific guidelines by reviewing clinical documentation and composing formal appeal letters. Maintain current knowledge of billing guidelines, FSCs, and coding standards while editing registration information per clinic policy. Cross-train in all Insurance Department areas and assist in training new employees and monitoring workflow. Act as a resource to peers and ensure special projects are completed efficiently.
Required Qualifications
- High School graduate or equivalent
- 3-6 years in a medical business office or related field
- Experience with the claims adjudication process for multiple governmental agencies and private insurance carriers
- Basic medical terminology
- Current CPT and ICD-10 coding experience
- Ability to assist new hires and others in detailed training processes
- An aptitude to retain detailed information
- Ability to be multi-tasked oriented, to prioritize and to produce an acceptable volume of work
- Excellent organizational and problem-solving skills
- Excellent communication skills, oral and written
- Basic knowledge of Windows-base computer applications
- Accurate typing rate of 40 wpm
- Ability to operate the following equipment: computer, copier, fax, web based payer sites, and 10-key calculator
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