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About the role
Key responsibilities & impact- Review, verify, and complete missing registration and insurance information on electronically received encounters
- Apply and correct billing details according to insurance carrier requirements and company policies
- Manage multiple client accounts according to assigned volume and productivity expectations
- Monitor and report low volumes, missing service dates, and missing insurance or payer information
- Use RICA coding application and AthenaIDX to update and correct demographic records
- Resolve demographic, insurance, and Patient Access-related errors, edits, and rejections
- Conduct verification checks and assign accurate payer information to support timely billing
- Take ownership of Level 2 escalations from the offshore team and resolve issues preventing claim submission
- Provide feedback and trending observations to the PA & EDI Supervisor
- Process work within two business days and notify the supervisor when not on target
- Complete daily production records accurately and on time
- Communicate workflow deviations and escalate issues affecting daily submission or month-end close
- Collaborate with Billing, Coding, Enrollment, EDI, and Leadership teams
- Participate in training, process improvements, and compliance with payer guidelines and internal workflows
- Adhere to company policies, safe work habits, confidentiality, and business standards
Requirements
What you’ll need- High school graduate or GED required
- Minimum of one year in the healthcare industry
- Strong attention to detail and accuracy
- Ability to interpret eligibility files and understand payer requirements, rules, and coverage limitations
- Knowledge of insurance types, payer hierarchy, and coordination of benefits
- Ability to work independently with minimal supervision, manage pressure, and meet established deadlines
- Computer literacy and proficiency with Microsoft Office; Excel required
- Excellent communication skills for collaboration with internal teams and external partners
- Ability to prioritize work and manage competing tasks
- Understanding of HIPAA and handling of Protected Health Information (PHI)
- Critical thinking and problem-solving abilities
- Experience with Athena IDX a plus
- Preferred insurance data entry / medical front office training and/or certification
Benefits
Comp & perks- Ongoing training, updates, and process improvement opportunities
