
Brings proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs.
• Bill no-fault and third-party liability carriers when appropriate
• Requests documentation from insurance representatives when no nofault insurance exists
• Review and research insurance claims to determine possible payment sources
• Contact various sources including insurance professionals, patients, and other parties to verify relevant data
• Request appropriate information, both verbally and written, from appropriate parties to ensure proper claim disposition
• Maintain and update payors on denied claims
• Ensure that appropriate billing guidelines and standards are met based on payor and/or state
• Make written or verbal appeals to payers on denied claims
• Obtain claim status and gathering supporting documentation to submit appeals