RCM Specialist
Valley View Surgery Center,
Apr 2023 - Aug 2024 (1 year 5 months)
Insurance Verification by verifying eligibility and benefits via Insurances Portal/calls. Calculating patient responsibility for the procedure and notifying them of their due Pre-DOS in adherence to No Surprise Act. Calling Physicians offices to obtain the Prior authorization required for certain procedures. Billing the charges to Insurance after charge posting by the medical coder. Following up with Insurances for claims status via Call/Portal. Managing denials and taking mandatory actions such as appeals, resubmissions, or calling insurance for sent back review. Working on reports of unpaid claims as an Accounts Receivable executive. Ensuring the reimbursement of claims and posting payments to patient accounts. Calling patients for necess