Handles all aspects of workers’ compensation claims from set-up to case closure ensuring strong customer relations are maintained throughout the process.
Reviews claim and policy information to provide background for investigation.
Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with insured, claimant, and medical providers.
Evaluates the facts gathered through the investigation to determine compensability of the claim.
Informs insureds, claimants, and attorneys of claim denials when applicable.
Performs follow-up on insurance billing and collection activities, verifying the accuracy and completeness of insurance records and claims, contacting insurance companies to expedite payments for physician services.
Compensation
$17.89 - $26.35 / Hourly
Responsibilities
Performs insurance follow-up billing and collection duties
Reviews patient accounts for accuracy
Utilizes Epic, system tools, and payer websites for claim submission and status
Consistently meets QA and efficiency standards
Interacts with management and staff to discuss issues
As our Billing Rep II, you will help our patients and providers streamline the billing and insurance process so they can focus on patient care and financial well-being. Every day you will review and process patient accounts, insurance claims, and payment postings. You will be expected to ensure accurate and timely billing, follow up on denied claims, and maintain patient confidentiality.
Responsibilities
Review and process patient accounts, insurance claims, and payment postings
Ensure accurate and timely billing
Follow up on denied claims
Maintain patient confidentiality
Read & interpret invoice details
Requirements
High School Diploma or GED
Nice to have: Associates in Healthcare Administration
Registered Nurse Assessment Coordinator – RNAC to assist with accurate and timely completion of both the RAI and Care Management process from admission to discharge.
Compensation
$40 to $43 per hour based on experience.
Responsibilities
Complete all required sections of the MDS
Intensive focus on Care Plans: creation, documentation, monitoring and leading the Care Plan meetings
Ensure documentation is present in the medical record to support MDS coding
Work in collaboration with the IDT to assess the needs and formulate a plan of care for the residents
Obtain and ensure Skilled Certification/Re-Certification documentation is accurate
Requirements
Licensed as a Registered Nurse - RN in Pennsylvania
Billing Rep IICHI Health · Rancho Cordova, US