Sentences with phrase «resolve claim denials»

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

Not exact matches

A Letter to Appeal a Medical Claim Denial is a first step to resolving the issue.

I am very familiar with resolving workers» comp denials and in filing workers» comp claims.

While other lawyers for disability cases may charge upfront or hourly fees, our firm will see your case on a contingency denial basis, financing your claim until it is successfully resolved.

To raise immunity one usually files a motion to dismiss but unlike most motions to dismiss, if there are factually issues that need to be clarified those are resolved in an immediate evidentiary hearing and a denial of a claim of immunity is subject to immediate appeal.

Reliable team player; LTC / closed door experience and FrameworkLTC software working knowledge is a plus Duties: - Verifying orders and clarifying information if needed - Data entry (patients, prescribers, payers, prescriptions, literal orders, etc.)- Adjudicating claims and resolving denials - Filling prescriptions using different type of packaging (vials, blister cards, unit dose, etc.)- Answering phone calls and assisting customers with their inquiries in a professional manner - Maintaining sufficient drug and supplies inventory and placing orders as needed - Keeping the pharmacy area clean - Performing other duties as needed

• 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 systems

Resolve complex billing denials related to coding errors by submitting Operative Reports to all insurance companies for claim reconsideration.

> Captures patient care data for the initial claim preparation > Registration of all patients, including insurance verification > Responsible for accurate and timely preparation of billing data > Validates all appropriate coding data for daily processing > Prepares electronic claims for submission to the appropriate payer > Obtains and submits copies of medical documentation as required or requested by third party payers > Reconciles insurance / patient payments > Assists in deposit preparation > Analyzes and resolves claim rejections and denials related to billing or provider issues > Assists in the compilation of monthly reports > Prepares, reviews, and completes patient statements submissions > Answers patient questions, identifies and resolves patient billing complaints > Assists in delinquent account review > Other duties as requested by the Billing Manager

CAREER HIGHLIGHTS • Over 5 years» dedicated experience in medical billing and coding field • Highly skilled in generating pre-bills and transmitting claims • Well versed in following up with payers, vendors and clearing agencies • Hands - on experience in resolving denial log entries running reports • Working knowledge of ICD - 9 / 10 and CPT coding, medical terminology and diagonosis procedures

Duties include working on denials & eligibility, communicating with insurance companies, verifying patient information, depositing cash & checks daily, transmitting electronic claims, and researching & resolving processing errors.

Claims Management Duties & Responsibilities Utilize efficient workflow organization to improve departmental efficiencies while ensuring effective client response and diligent analysis of claims, with extensive experience in both commercial and personal lines Provide relevant administration and direction to multi-million dollar staff budgets, quality control, fraud investigations, and complex claims reviews, earning denial authority over high - level claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professioClaims Management Duties & Responsibilities Utilize efficient workflow organization to improve departmental efficiencies while ensuring effective client response and diligent analysis of claims, with extensive experience in both commercial and personal lines Provide relevant administration and direction to multi-million dollar staff budgets, quality control, fraud investigations, and complex claims reviews, earning denial authority over high - level claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professioclaims, with extensive experience in both commercial and personal lines Provide relevant administration and direction to multi-million dollar staff budgets, quality control, fraud investigations, and complex claims reviews, earning denial authority over high - level claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professioclaims reviews, earning denial authority over high - level claims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professioclaims cases Identify and develop talent among team members with focused training efforts, performance reporting and analyses, and operational efficiency initiatives Deliver continuous assessment of work force, while furnishing oversight and guidance regarding effective service strategies and techniques, loss liability monitoring, and claim litigation assistance Develop and implement the marketing and sales efforts of customer service team while tracking progress versus established internal and external benchmarks, providing disciplinary actions when necessary Construct customer service and claims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professioclaims team through effective staff hiring to aid in efficient operations and execution, delegating important tasks / assigments to line supervisors while providing branch - level guidance Aid in strategic planning and capital budgeting based on improving operating efficiency and reducing service - related production losses, collaborating effectively with senior - level management Maintain a strong working knowledge of important industry topics, company programs and policies, and overall regulatory environment, including state - level responsibility for process changes in casualty / PIP Address important client and staff queries, resolving them in an expedited manner Lead through example with consistent work ethic, attitude and professionalism