About this role
Understands payer requirements per hospital contracts and payer policies, ensuring adherence to all payer requirements. Knowledge of payer contracts specific to timely filing deadlines and retro-authorization timelines. Collaborates with various departments throughout the organization to confirm all necessary information for the appeal is accurate and supported through medical documentation. Collaborate with Billing Representatives to ensure appeals and/or additional documentation is provided timely for reimbursement, collecting data and creating appeal based on payer requirements. Reviews denial type, payor authorization approval information documented on the account, confirms timely claim submission as required by the payer.