Overall Purpose of the Position:
Responsible for the accurate and timely processing of claims.
Responsibilities of Job:
75% Researches and processes claims according to business regulation, internal standards and processing guidelines. Verifies the coding of procedure and diagnosis codes.
20% Resolves system edits, audits and claims errors through research and use of approved references and investigative sources.
5% - Coordinates with internal departments to work edits and deferrals, updating the patient identification, other health insurance, provider identification and other files as necessary.