Essential Duties & Responsibilities
- Manage assigned insurance AR worklists daily.
- Follow up on unpaid, underpaid, and denied claims.
- Review payer portals and contact payers for claim resolution.
- Submit corrected claims and timely appeals.
- Identify reimbursement trends and escalate payer issues.
- Verify contractual reimbursement and pursue underpayments.
- Maintain complete documentation including actions, contacts, reference numbers, and next follow-up dates.
- Collaborate with Billing, Cash Posting, Scheduling, Authorization, Credentialing, and Leadership.
- Maintain compliance with CMS, HIPAA, Medicare, commercial payer rules, and company policies.
Waystar Responsibilities
- Utilize Waystar daily for claim status, edits, rejections, and corrected claims.
- Review clearinghouse reports and resolve claim edits promptly.
- Monitor ERA processing and coordinate payment posting issues.
- Work electronic rejection queues within established turnaround times.
- Support ERA/EFT enrollment and clearinghouse issue resolution.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.
