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Claims Officer (160752)

Review all lab requisitions with patients and doctor’s offices to determine accuracy with ICD-9 and CPT codes.
Research (ICD) and CPT Current Procedure Terminology codes to obtain maximum reimbursement.
Review ICD-10/CPT coding to ensured proper billing on EMR.
Estimate the patient’s financial responsibility after verifying their benefits.
Performed monthly re-certification for expiring authorizations to ensure patient demographics, insurance information, verification and eligibility are current.
Maintained audit system according to policy and procedures to assure completeness, accuracy, and internal consistency.
Mitigate risk for any billing Issues and potential reimbursements, research and resubmit denied claims.
Update all unpaid claims to insurance plan.
Verify approvals for insurance patients through online website portals.
Observe strict confidentiality and safeguarded all patient-related information
Organize and led weekly personnel meetings with team members.
Coordinate compliance program (creation of office manual, policies and required forms).
Complete authorization and per-certification for medical treatment for patients who need special CPT codes approvals.