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Manage full-cycle billing for multi-specialty practices; submit accurate CMS-1500/UBn04 claims via Availity, Change Healthcare, and payer portals
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Own A/R worklists and targeted follow-ups; correct edits, execute rebills/voids, and escalate with payers to reduce aging and speed cash
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Resolve denials by analyzing ERAs/EOBs; fix coding/modifier, COB, NPI/Tax ID, and authorization issues; write clear, timely appeals
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Verify eligibility/benefits across Medicare, Medicaid, commercial, and WC; coordinate prior authorizations and referrals to prevent rejections
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Partner with providers/coders to improve documentation and charge capture; maintain fee schedules and payer rules in PM/EHR
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Track KPIs (clean-claim rate, denial rate, days in A/R) and implement workflow improvements that shorten claim turnaround times
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Train new hires on payer guidelines, clearinghouse workflows, HIPAA/privacy, and best practices
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Results: Recovered payment on 90% of denied/rejected claims; consistently exceeded productivity and quality standards