The Insurance Follow-up Specialist is responsible for monitoring outstanding insurance claims to ensure timely and accurate payment. They must resolve discrepancies, communicate with insurance companies and clinical staff, and maintain detailed documentation in compliance with regulatory standards.
The Code Edit Analyst performs daily coding reviews on claims to validate ICD-10, CPT, and HCPCS codes while ensuring compliance with medical necessity requirements. They also develop reports, analyze audit outcomes, and assist in process improvement initiatives to optimize revenue cycle performance.
The Senior Reimbursement Analyst manages net revenue integrity, prepares annual cost reports, and coordinates audits for Medicare and Medicaid. They also provide analytical support for financial planning, maintain reserve models, and recommend process improvements for reimbursement services.
The Coding Specialist reviews medical record documentation to assign accurate diagnostic and procedural codes for a multi-specialty physician group. They are responsible for maintaining coding accuracy, managing claims edits, and ensuring compliance with regulatory guidelines.
The Coding Specialist reviews medical record documentation to assign accurate diagnostic and procedural codes for a multi-specialty physician group. They are responsible for maintaining coding accuracy, managing claims edits, and ensuring compliance with regulatory guidelines.
The Team Lead oversees credit balance resolution staff, providing training and monitoring daily workflows to ensure accurate reconciliation of accounts. They are responsible for resolving complex credit balances, undistributed payments, and refund requests while maintaining compliance with regulatory and contractual requirements.
