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Responsible for insurance claims and billing across Unified Clinics. Manages payments via General Ledger, ensuring accurate fund and cost center transfers. Maintains and verifies data in database. Identifies and resolves payment discrepancies

• Verifies and corrects claims data, generates claims into text files for uploads. Utilizes Explanation of Benefits to manually bill insurance claims.
• Follows up on denied claims. Contacts clients to gather claim information and addresses their inquiries about claims.
• Composes and obtains treatment authorizations from multiple insurance entities for multiple clinics. Verifies active insurance coverage.
• Collects remittances from insurers, enters payments into medical billing database, and verifies payments. Responsible for billing monthly statements to clients.
• Offers support in various areas as required, including processing refunds and requesting contracts and fee schedules from insurance carriers. Collaborates with leadership and other stakeholders to evaluate budgetary requirements. May assist in the budgetary process and developing and overseeing budgets and project expenditures.
• Designs and produces various reports.

Minimum qualifications based upon job documentation and industry best practices. Any current employees not meeting these qualifications will be grandfathered until they move to a different job.

• Associate's degree or two years' college coursework in a related field from an accredited institution

• One year's relevant experience
• Experience with budget management.
• Experience with office software, including word processing, spreadsheets, and presentation software. Experience with accounting systems.
• Experience with insurance coding and billing, insurance verification and credentialing.

Office or other indoor work with minimal physical demands such as occasionally lifting or moving materials less than 25 pounds.

Work is generally performed in a well-lit, temperature-controlled indoor environment with occasional exposure to the outdoors or any number of elements.

Revised: 2024-06-19