Process and submit accurate insurance claims weekly to commercial and government payers using EHR systems.

Reduced accounts receivable aging from 60 days to 30 days through proactive follow-up on unpaid claims.

Analyze and appeal denied claims, improving first-pass claim acceptance rate to 96%.

Verify CPT, ICD-10, and HCPCS codes for accuracy and compliance to maximize reimbursement.

Respond to patient billing inquiries and establish payment arrangements when needed.

Verify insurance eligibility and obtain prior authorizations prior to scheduled appointments.

Generate claims and remittance advice using provider portals.

Maintain strict compliance with HIPAA regulations to protect patient financial and medical information.

Review patient records and pathology reports for accuracy and billing compliance.

Analyze EOBs and insurance payment activity to ensure accurate reimbursement.

Investigate and resolve billing issues through follow-up with insurance companies and internal teams.

Initiate appeals with insurers based on payer guidelines and supporting medical documentation.

Research payer denials related to authorization requirements, medical necessity, and coverage policies.

Conduct peer-to-peer review coordination with payers and clinical teams when necessary.

Identify denial trends and escalate patterns to leadership for revenue cycle improvement.

Maintain confidentiality and safeguard sensitive patient and financial information.

Reviewed patient records and pathology reports to ensure billing accuracy.

Determined appropriate CPT, ICD-10, and HCPCS codes for services rendered.

Followed up with payers regarding claim status, denials, and delayed payments.

Generated claims and remittance advice through provider portals.

Researched and appealed denied claims in accordance with Medicare, Medicaid, and commercial payer guidelines.

Identified denial patterns and collaborated with leadership to address root causes.

Assisted with complex billing workflows and specialized follow-up processes.

Reviewed medical documentation and pathology reports for billing accuracy.

Analyzed EOBs to ensure proper reimbursement from insurance providers.

Researched claim denials and initiated detailed appeals with supporting documentation.

Served as a resource for hospital case management departments regarding concurrent denials.

Coordinated Medicare status determinations and compliance requirements.

Assisted with specialized billing workflows and revenue cycle improvements.

Greeted patients and documented concerns while ensuring accurate patient records.

Verified insurance coverage and prepared patient charts and authorizations.

Scheduled and confirmed patient appointments.

Provided clear explanations of healthcare programs and benefits to patients.

Maintained a high level of customer service with patients, providers, and staff.

Coordinated patient intake processes including vitals, medical history, and visit preparation.

Completed diagnostic and procedure coding for billing accuracy.

Maintained secure and confidential medical records.

Ensured compliance with healthcare regulations and operational standards.

Assisted residents with daily personal care needs including bathing, feeding, and mobility.

Monitored patient conditions and reported abnormalities to nursing staff.

Maintained patient confidentiality and safety standards.

Managed office filing systems, records, and administrative documentation.

Processed timesheets, spreadsheets, and departmental reports.

Answered multi-line phones and directed inquiries appropriately.