Under general supervision by the department’s Supervisor, Team Lead, and Manager of Reconciliation and Reimbursement, this position is responsible for the accuracy and integrity of all monies received to AHS.   

Obtain status on Non-Governmental outstanding accounts receivable, EOBs and follow up with insurance payors on claims  

Reviewing contracts for accurate payments and identifying payor trend issues with payment or codes. Ability to understand insurance terms, (i.e. HMO, PPO, EOB, Remit, Stop Loss, etc). Strong data and organization skills Notate all accounts with outcome/resolution and/or next steps Extensive insurance follow-up for various insurance plans  Working denials, submitting appeals, and correcting claims thorough knowledge and understanding of insurance plan policy updates including authorization and medical necessity requirements. Insurance refund processing Overall awareness of specific insurance plans accounts receivable issues. Ensure insurance information is entered on accounts accurately regarding primary, secondary and tertiary coverage that is received from patients. Performs all other duties as required by the supervisor/manager.  Must maintain up-to-date knowledge of departmental policies and procedures by attending department meetings and trainings (online and classroom).