Medical Collections Representative

Claims Processing: investigate insurance claims; properly resolve by follow-up & disposition.

• Verify patient eligibility with secondary insurance company when necessary.

• Bill private primary insurance claims and all supplemental insurances including all Medicaid states on paper and online.

• Mailing of all paper claims.

• Investigate and update the ARMS database with all Remittance Advices received from secondary insurance companies.

• Ensure that all information given by representatives is accurate by cross referencing with the patient's account, followed by using honest judgment in any changes that may need to be made.

• Process denials & rejections for re-submission (billing) in accordance with company policy, regulations, or third party policy.

• Check Verification: Investigate & ensure actual payment is received for all DOS payment notifications, prior to posting payment; update the CPPR database after receiving payment.

• Update patient files for insurance information, Medicare status, and other changes as necessary or required.