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 support process improvement initiatives for coding, billing, and collections activities associated with Denial Prevention.

RESPONSIBILITIES

• Monitors compliance of rules and the contractual terms and agreement with insurance companies and DOH Guidelines.


• Ensures compliance by the facility pricing structure and the rules for the different patient categories (including self‑payer) with implementation.


• Prepares submission 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 produc...