Overseeing the operational aspects of handling credit balances and refund requests within a specific providers. Making sure that the team is hitting the KPI's on a monthly basis on top of maintaining the quality of work.
Responsibilities includes:
- AR(account receivables) follow ups and resolution Audits
- Reviewing outstanding claim denials, disputes and PRA's
- Answers general and provider specific questions
- Provide provider and company updates or changes.
- Client POC
- Quality Assurance Analysis and following standards
- New Hire Onboarding
- Compliance review and monitoring
- Process Quality Improvement
- Performance review and developmental Coaching
- Workflow and Inventory management
- Reporting and data analysis
Additional knowledge:
- Claim handling experience for Hospital and Physician billing.
- Proficiency in EPIC system
- Expertise in claim processing
- Expertise in processing claim denials, disputes and PRA's
- Expertise in HCFA and UB04 review
