SCOPE / GENERAL PURPOSE OF JOB:
Responsible for timely daily claim submissions and file maintenance functions in accordance with RC Billing standards and Reimbursement policy and procedures, including patient billing/EPS, claim submissions electronic and paper, and file maintenance. Is responsible for seeking resolution to problems relating to timely and efficient claim submissions while ensuring excellent communication between the AR department, CBO management, Revenue Cycle IT Department and the Revenue Cycle Credentialing Department while ensuring client satisfaction. Responsible for timely completion of all client Allscripts Pro PM database file builds and Waystar EDIInsight file builds to include documentation and follow-up processes through to completion. Responsible for daily file maintenance within Allscripts Tiger, Allscripts Pro PM and Waystar EDIInsight. Responsible for ensuring daily claim submissions for all clients are successful and monitoring clearinghouse and payor submission edits preventing successful claim submission, ID trends and/or resolution is being sought timely by the AR Department. Responsible for balancing, daily/monthly closing of all databases and preparing month end reporting packages. Responsible for contacting Allscripts or Waystar EDIInsight and working with them directly to timely resolve claim submission issues, patient statement processing issues and HL7 ADT and DFT Interface issues.
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