Billing and Revenue Recovery Officer-Billing and Recoveries

Job Description

Job holder is responsible for the identification, mitigation, and prevention of denials along with preparing reports on clinical disputes based on the criteria documented. Assists with day-to-day revenue cycle denial operations and supports process improvement initiatives for coding, billing, and collections activities associated with denial prevention.

Responsibilities

• Monitors compliance with rules and contractual terms and agreement with insurance companies and DOH guidelines.
• Ensures compliance with the facility pricing structure and the rules for different patient categories (including self-payer) with implementation.
• Prepares submissions for all patient invoices (claims) electronically.
• Maintains and reports incorrect charges and charges not captured to Team Billing Lead or Billing Manager. Bills all secondary claims processed on a daily basis that are produced by the billing system.
• E...