External Job Description and Responsibilities
JOB DESCRIPTION OVERVIEW:
Position is responsible for reviewing assigned denials to ensure claims are being processed correctly and efficiently.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Reviews assigned denials to determine appropriate action based on payer requirements.
- Assembles and prepares required documentation for appeal in billing system to appeal disputed claims.
- Assembles and forwards required documentation for payer guidelines.
- Maintains working knowledge of carrier requirements for claim appeals and claim appeal billing systems.
- Identifies and report consistent errors that impact claims from being processed correctly.
- Performs additional duties and assignments as requested.
