Manage assigned insurance accounts receivable by investigating unpaid, denied, delayed, and underpaid claims, and pursue resolution through payer follow-up, corrected claims, appeals, and supporting documentation. Maintain accurate, compliant account records, monitor AR and denial trends, collaborate with internal revenue cycle teams, and escalate unresolved or recurring issues.
The Certified Coder is responsible for accurately coding hospital procedures using ICD-10 and CPT guidelines while managing patient demographic information and charge posting. They also handle insurance authorizations, resolve coding issues, and audit E/M documentation to ensure compliance with legislative changes.
The RCM Associate is responsible for managing insurance accounts receivable, resolving outstanding payer balances, and addressing denials to ensure timely reimbursement. They must also collaborate with internal teams to identify root causes of claim issues and maintain accurate, audit-ready documentation.
The Pre-certification Specialist is responsible for obtaining surgery pre-certifications and coordinating medical information with insurance companies. They must also maintain accurate patient records and address inquiries regarding surgery authorization status.
The RCM Lead supports daily front-end revenue cycle operations, including patient access, insurance verification, and financial clearance. They also provide workflow guidance, staff training, and monitor productivity to ensure accurate and timely service.
