Sentences with phrase «handling claim denials»

Reading EOB's, Handling Claim Denials and Filing Appeals

• Hands - on experience in handling claim denials and resubmissions using standard adjudication procedures.

Not exact matches

All cases of denial in the predicate may be handled in this fashion, Reese claims.

Denial is absolutely the standard way such claims would be handled, and any deviation from that involves an adjuster or a court creatively construing a policy in favor of the insured.

He has successfully handled cases involving brain injury, plane crashes, stock fraud, truck wrecks, deadly exposure to negligently manufactured drugs, intoxicated or drug impaired drivers who injure innocent citizens, negligent road construction and maintenance, negligent design or manufacture of machines, explosions and home fires, violation of DOT regulations regarding 18 wheelers, severe burns and scars, negligent installation of hot water heaters, wrongful denial of claims by insurance companies, sale of alcohol to minors by convenience stores, defective residential or commercial construction, heart attacks at work from overexertion, defective airbags, wrecks caused by trucks that exceeded size and weight limits, nursing home abuse, product liability, unrelenting pain from on - the - job injuries, and numerous other cases where the injuries were so severe that the person died or became totally disabled.

Whereas other law firms may handle only claim denials, for example, we offer guidance when you file a workers» compensation claim and while you are being paid benefits.

Weil has extensive experience handling high - profile ERISA class actions involving claims for breach of fiduciary duty and improper benefit denials and reductions.

Many times people use the Emergency Room instead of Urgent Care without realizing, a visit to the emergency room that could be handled by an urgent care center may result in a claim denial if the patient was not in a life - threatening medical emergency.

Claims - handling delays topped the complaint list, (16 %) followed by denial of claims (14 %) and unsatisfactory settlement offers (Claims - handling delays topped the complaint list, (16 %) followed by denial of claims (14 %) and unsatisfactory settlement offers (claims (14 %) and unsatisfactory settlement offers (11 %).

Denial is absolutely the standard way such claims would be handled, and any deviation from that involves an adjuster or a court creatively construing a policy in favor of the insured.

Efficiently handled functions of medical billing for the company and all areas related to billing such as ensuring proper ICD - 9 and CPT coding, following up on any unpaid claims, and appealing denials

Handle correspondence from insurance companies regarding billing questions, billing issues, and medical claim denials.

Ajilon, Duluth, MN 1/2007 to 5/2011 Medical Biller • Collected information about delinquent accounts and contacted customers to provide them with information on how to pay them back • Reviewed patients» bills for accuracy and attempted to collect missing information • Followed up on unpaid claims with insurance companies and determined reasons for non-payment • Determined reasons for denied claims by interviewing insurance company representatives over the telephone • Checked insurance payments to ensure that they are in compliance with contract discounts • Handled discrepancies in payments by investigating causes and making allowances for mistakes • Respond to patients» information regarding billing services and denials

Responsible for insurance aging reports, research and resolve claim denials, appeals, incorrect payments, refunds, and handle collections on unpaid patient accounts.

Position Overview A dental insurance coordinator is hired by dental services facilities, or dental support facilities, where his or her primary work is to ensure that patients are provided with the right information on their insurance coverages and that any unpaid claims or denials are handled properly.

• Assess all insurance claims against patient services rendered and make a to do list • Assist patients in filling our insurance claim forms and verify form data • Ask questions to assist in determining out any ambiguous information • Verify completeness of information on medical insurance forms • Post insurance billing information data into predefined database systems • Make list of insurance companies to contact for billing purposes • Determine how to approach each insurance company on the list, based on its reputation • Contact insurance companies to determine status of claims • Follow up on unpaid claims, including denial, exceptions and exclusions • Ask why claims have been denied and provide relevant correlating information • Resubmit denied claims with additional information to prove denial is inappropriate • Provide information to collection agencies regarding delinquent or past due accounts • Prepare and submit secondary claims for patients with more than one insurance coverage • Maintain understanding of managed care authorizations and limit coverage to a certain number • Verify patients» benefits eligibility and coverage expanse • Maintain knowledge of ICD9 and CPT treatments to be able to handle data entry and claim check duties appropriately • Gather and maintain patient data including medical histories, insurance identification and diagnosis

Previous experience to include handling prior authorizations, appeals, denials and the ability to analyze claims for errors and resubmissions.

• Process cash receipts and postings for payments made by ACH, lockbox, wire, and other avenues • Handle insurance claims and follow up with the relevant insurance company to make certain that each claim is paid timely, and handle resubmitting of claims • Work to reduce claim denial turnaround, as well as resolve payment variances by working with relevant clients and in - house managers • Perform account reconciliations by constant examination of invoicing and payment • Manage inquiries and individual concerns to reduce problems and complaints • Enter all changes daily in relevant software, and make recommendations for improvement of software and documentation sHandle insurance claims and follow up with the relevant insurance company to make certain that each claim is paid timely, and handle resubmitting of claims • Work to reduce claim denial turnaround, as well as resolve payment variances by working with relevant clients and in - house managers • Perform account reconciliations by constant examination of invoicing and payment • Manage inquiries and individual concerns to reduce problems and complaints • Enter all changes daily in relevant software, and make recommendations for improvement of software and documentation shandle resubmitting of claims • Work to reduce claim denial turnaround, as well as resolve payment variances by working with relevant clients and in - house managers • Perform account reconciliations by constant examination of invoicing and payment • Manage inquiries and individual concerns to reduce problems and complaints • Enter all changes daily in relevant software, and make recommendations for improvement of software and documentation systems

• Working knowledge of ICD - 9 and ICD - 10 and OASIS • Excellent skills in reviewing delinquent accounts and creating avenues for overdue payments • Demonstrated expertise in translating medical procedures into codes that can be easily translated by payers and medical facilities • Proficient in appropriately and confidentially handling patient treatment, diagnosis and procedural information • Well - versed in investigating rejected claims and ensuring that they are resubmitted and paid • Special talent for investigating insurance fraud and determining ways to counter / avoid sticky situations • Skilled in verifying and completing charge information in company defined databases • Familiar with documentation needs (and manners of obtaining them) for insurance claims submission and approval • Qualified to work efficiently with external collection agencies to ensure maximization of reimbursement • Particularly effective in handling appeals for denials by employing exceptional knowledge of carriers and appeal processes • Special talent for increasing reimbursements by investigating denied claims and providing alternatives to denials