Collections Claims Clerk
$1,000 per monthGlobalchannelmanagement
Collections Claims Clerk requires:
- Claims
- Collections
- V-lookup denials and action codes from denial log spreadsheet.
- Run query to pull in batch and check numbers associated with claims.
- Research credits to determine whether there are two payments applied to the claim or if there is an overpayment.
- Determine whether a refund is due to insurance or member.
- If there is a refund due, complete refund request. If there are two payments applied and one belongs to a different invoice, complete redirect.
- Open claims with no payment, nor denial, see resubmit instructions.
- If a claim has already been resubmitted and still neither payment, nor denial has been received, contact payer to check status of the claim and work towards a resolution.
- Once all actions have been determined, send write offs for approval to supervisor. For all write offs over $1000, they must be approved by finance manager.
- Identify trends within payers to find issues. If there is an issue within plan set up, forward it to be corrected. Work with payer relations and/or payer directly to resolve outstanding issues affecting payment.
- Complete all actions: write offs, resubmits, calls, e-mails and post V-lookup denials and action codes from denial log spreadsheet.
- Run query to pull in batch and check numbers associated with claims. Research in Filebound for additional denials.
- Research credits to determine whether there are two payments applied to the claim or if there is an overpayment. Determine whether a refund is due to insurance or member. If there is a refund due, complete refund request. If there are two payments applied and one belongs to a different invoice, complete redirect.
- Open claims with no payment, nor denial, see resubmit instructions.
- If a claim has already been resubmitted and still neither payment, nor denial has been received, contact payer to check status of the claim and work towards a resolution.
- Once all actions have been determined, send write offs for approval to supervisor. For all write offs over $1000, they must be approved by finance manager.
- Identify trends within payers to find issues. If there is an issue within plan set up, forward it to be corrected. Work with payer relations and/or payer directly to resolve outstanding issues affecting payment.
- Complete all actions: write offs, resubmits, calls, e-mails and post for auditing.
Vacancy posted 3 days ago
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