Medical Billing and Coding

• Verify patient eligibility, benefits, and coverage before services are rendered
• Identify authorization requirements, coverage limitations, deductibles, coinsurance, and copays
• Review and understand TPA requirements and guidelines
• Communicate benefit information and insurance requirements to providers and staff
• Assist front office teams with insurance-related questions
• Maintain accurate insurance information in the patient management system
• Monitor payer policy changes and reimbursement requirements
• Prepare, review, and submit clean claims accurately and timely
• Monitor claim acceptance and resolve submission errors
• Follow up on unpaid or pending claims
• Research and resolve claim processing issues
• Investigate denied claims and payment discrepancies
• Submit corrected claims, reconsiderations, and appeals
• Identify denial trends and recommend process improvements
• Post insurance and patient payments
• Reconcile account balances, adjustments, and payment variances
• Manage aging reports and outstanding balances
• Follow up on underpayments and unpaid claims
• Support collection and reimbursement goals
• Maintain relationships with insurance carriers and payer representatives
• Stay informed of payer policies and reimbursement updates
• Maintain compliance with Medicare, Medicaid, commercial payer requirements, HIPAA regulations, and company policies
• Assist with audits, reporting, and quality assurance initiatives
• Support the patient journey from insurance verification through final payment collection
• Collaborate with providers, administrative staff, and team lead to improve operational efficiency and reimbursement outcomes
• Participate in process improvement initiatives and special projects

Explore Healthcare Billing & Insurance Coordinator at CQ Partners. Review requirements and application details.