Complete Care Partners

Key Responsibilities:Claims and Billing Operations. Prepare, review, and submit insurance claims (electronic and paper when needed) for professional and or facility services. Verify that claims include accurate patient demographics, insurance information, authorizations, diagnosis codes, procedure codes, modifiers, units, and supporting documentation as applicable. Maintain clean claim workflows and resolve claim edits and clearinghouse rejections promptly. A/R Follow-Up and Denials Management. Monitor accounts receivable aging and prioritize follow-up based on payer rules, dollar value, and timely filing limits. Investigate and resolve denials, underpayments, and request for information (medical records, referrals, authorizations). Submit corrected claims and appeals with appropriate documentation and accurate coding support. Payments and Patient Billing. Post and reconcile payments and adjustments from ERAs and EOBs. Identify and escalate payer payment variances and contract...