- Contacts insurance company regarding outstanding balances.
- Determines denial reason and send in appeals/redeterminations/reconsiderations.
- Files for ALJ's, prepares the argument, and attends the hearing.
- Reviews and prepares prepay and post pay audits foe Medicare and commercial payers.
- Rebills insurance companies or other third parties to secure payment for patients.
- Processes insurance payments to patient accounts in Brightree.
- Run Aging report for follow up denials/or claims not worked.
- Creates and mails insurance claims and patient statements, if necessary
- Verifies all entries made by front end and makes corrections if necessary.
- Makes recommendations to management for write-offs.
- Makes recommendations on trending issues with Acu notes report to determine changes that need to be made to increase collections and correct front end errors
- Other duties as assigned
- Experience with all the above responsibilities
- Prior audit experience
- Insurance verification experience, and payor knowledge for Medicare and Commercial insurances
- Working knowledge of durable medical equipment as it applies to the above
- Brightree experience is a plus
- Excellent time management skills with strong attention to detail
- Computer proficiency, along with the ability to type
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Accounts Receivable and Audit Specialist - Marlton, United States - SUNMED MEDICAL SYSTEMS LLC
3 weeks ago
Description
Job Description
Job DescriptionResponsibilities
Qualifications
Further consideration on compensation possible based on experience.
Company DescriptionSunMED Medical is a nationally accredited provider of specialized medical equipment to patients in the home care setting.We hold national as well as regional contracts with private insurance carriers as well as Medicare and Medicaid plans.
Company Description
SunMED Medical is a nationally accredited provider of specialized medical equipment to patients in the home care setting. \rWe hold national as well as regional contracts with private insurance carriers as well as Medicare and Medicaid plans.
