Additional Info

1. Reviews third party accounts to ensure that there are no complications which could hinder recovery. 
2. Contact third parties to obtain payment and change account type if applicable. 
3. Compose appropriate correspondence to solve billing problems and answer inquiries from patients and third party payers.
4. Conduct audit trails to retrieve lost or misapplied payments. 
5. Contact service areas for required additional forms and documentation as needed. 
6. Enter proper coding of procedures using Current Procedural Terminology (CPT-4), diagnoses using International Classification of Diseases (ICD-10), demographics, and special coding when required. 
7. Research diagnosis and work with clinic staff to obtain diagnosis for outpatient services. 
8. Request special billing functions through the computer, i.e., manual claims and statements. 
9. Respond to patient and third party inquiries and requests. 

1. Review, correct, and resubmit claims as necessary. 
2. Review and research denials and request information for possible resubmission to insurance companies. 
3. Obtain and submit medical records and laboratory results when required for claim adjudication. 
4. Follow up with insurance companies and third party payers to complete claim processing. 
5. Other duties as assigned. 

Determined within a relatively short period of time

NA

Medium impact to department

Training and supervision will be done RPS manager

No

NA

Office

NA

NA

NA

NA

NA