Manager

• Properly coding services, procedures, diagnoses, and treatments as needed
• Preparing and sending claims for payment
• Providing credentialing oversite for the Allcare credentialing team
• Verify coverage and eligibility for medical services
• Communicate with insurance providers and patients
• Review patient bills and correct any missing or inaccurate information
• Assist with timely resolution to billing/claim edits or “holds” in the PM system
• Use billing software to prepare and transmit claims
• Responsible for validating coding and billing information required to clear edits
• Follow the coding and compliance program as created by the Coding and Compliance manager including, controls and compliance measurements consistent with operation policies and documentation
• Work directly with providers in correcting coding and documentation as needed
• Accurately capture appropriate coding by reviewing encounter documentation
• Collect unpaid claims and clear up discrepancies
• Identifying and billing secondary or tertiary insurances
• Work with patients to set up payment plans
• Assist with following up on unpaid claims within standard billing cycle timeframe
• Assist with payment/remit issues to ensure timely posting of all transactions
• Maintain patient, physician, and financial confidentiality
• Participate in professional development activities and maintain professional affiliations
• Other duties as assigned

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