-Completes assigned accounts within assigned work queues.
-Obtains the maximum amount of reimbursement by evaluating claims at the contract rate with the use of the contract management tool for proper pricing (Examples: APC, DRG, APRDRG).
-Reviews and initiates the initial appeal for underpayments observing all timely requirements to secure reimbursement due to Hoag.
-Reviews and completes payor and/or patient correspondence in a timely manner.
-Escalates to the payor and/or patient accounts that need to be appealed due to improper billing, coding and/or underpayments.
Required Skills & Experience:
-One year of previous hospital business experience, or equivalent required or strong background in customer service.
-Basic experience with insurance plans, hospital reimbursement methodology, and/or ICD10 and CPT coding.
Required Education:
-High school diploma or equivalent required.