2 jobs found in Inverness

POSITION SUMMARY This position is responsible for investigating, resolving, and appealing denied medical insurance claims to maximize revenue and minimize outstanding accounts receivable. This role requires a strong understanding of insurance guidelines, billing codes, and medical documentation standards. ESSENTIAL DUTIES AND RESPONSIBILITIES Process denied claims and follow up with insurance companies to resolve discrepancies or reimbursement issues. Audit patient charts to confirm proper coding and documentation for billing accuracy. Read, analyze, and interpret Explanation of Benefits (EOBs) to determine next steps for claim resolution. Ensure all denials are submitted with complete and accurate information. Ensure that denials are worked on daily and assist with tasks as assigned. Process electronic and paper payment postings efficiently and accurately. Communicate regularly with administrative and clinical staff, preparing detailed reports for...

POSITION SUMMARY This role plays a vital part in maintaining the integrity of our revenue cycle by verifying documentation accuracy and reducing denial occurrences through auditing and accurate coding. The employee will have strong analytical skills, a deep understanding of medical terminology and coding standards, and a commitment to ensuring billing accuracy and compliance with regulatory guidelines. ESSENTIAL DUTIES AND RESPONSIBILITIES Review and assign appropriate CPT, ICD-10-CM, and HCPCS codes based on physician charges, accessing hospital portals to verify that all billing codes accurately reflect documented patient services and procedures. Ensure that patient record documentation meets coding and compliance requirements. Collaborate with the Denials Department to identify and analyze recurring patterns of omissions, errors, or documentation discrepancies. Communicate findings to Administration to elicit corrective actions and reduce future issues....