Responsibilities:

• Perform eligibility checks on patients electronically or by telephone for all scheduled visits for the practice.
• Clears up all eligibility errors in Phreesia and documents accordingly.
• Answer insurance verification questions from staff and patients.
• Follow procedures for proper authorization and processing of all referral services.
• Ensures that all prior authorizations have been obtained and notated appropriately.
• Troubleshoots any issues with patient eligibility/authorizations and communicates to the correct departments.
• Runs charge report for previous day and reviews for accuracy of codes/place of service/rendering providers and sends to billing department.
• Notifies physicians regarding billing discrepancies and missing charges.
• Updates office visit with appropriate codes rejected on first pass with billing system.
• Investigate patient inquires and disputes for services billed and communicate with billing department.
• Liaison between the billing department and physicians regarding insurance denials and requests for letters of medical necessity.
• Manages all unsigned office progress notes and communicates with the billing department on progress twice a week.
• Maintains and updates work duty spreadsheets daily.
• Ensures strict confidentiality of all health records, member information and follows HIPAA guidelines.