Procedural Knowledge Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract. Bundle appropriately based on CPT code rule and payer billing guidelines. Resolves POS vs. CPT code discrepancies. Verify E/M code type such as New vs. Establish patients and level of service. Responsi

Procedural Knowledge Responsible for maintaining and monitoring the day to day processing of assigned work queues as identified by the Production Unit Manager. Assists the Production Unit Manager in identifying trends in revenue cycle. Assists the Production Unit Manager in training new staff and existing staff members. Provide feedback regarding problems to management an

Responsible for all aspects of coding, quality assurance and compliance with Federal payer documentation guidelines. Works closely with Office of Compliance for Professional Fee Services to include review of documentation. Serves as departmental expert on coding questions. Exercises independent judgment and decision making on a regular basis with respect to code selection

Uses A/R follow up systems and reports to identify unpaid claims for collection/appeal. Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract. Review and update patient registration information (demographic and insurance) as needed. Resolves claim edits as needed. Applies appr

Procedural Knowledge Responsible for the processing of refunds and resolving credit balances. Prepares check requests via EPIC and SAP System for accounts payable department. Exchanges information with individuals outside the assigned department or institution. Ability to research and answers refund questions. Responsible for the reconciliation of refunds and wire transfe

Sort Lockboxes and flag EFT monies. Post payments and rejections (manual & electronic) in Epic. Posts Time of Service, credit card deposits and journal vouchers to the Epic system. Interacts with clinic and billing office staff. Post auto self pay file. Obtains documentation, organizes, prepares and posts negative remittances from third party payers continuing to track un