Specialist II, ROPS (Lab)
Core
Secure maximum reimbursement on medical claims by initiating collection follow-ups, resolving denials, and appealing underpayments with insurance payers.
Role type
Senior IC medical billing specialist (collections)
Builds
Claim adjustments and appeals for kidney care patients
Domain
Healthcare / Medical Billing
Required skills
Insurance claim adjudication, denial management, appeals processing, medical documentation retrieval, A/R system proficiency, MS Office (Word, Excel, Outlook)
Responsibilities
Initiate collection follow-up on denied claims, research and resolve claim rejections and underpayments, process claims and re-bills, request medical documentation from facilities, document daily follow-up in A/R system, validate insurance changes