Case Manager - Physician Practice jobs in Tennessee

Essential Duties and Responsibilities

1. Reviews workflow dashboards and makes correction to claims to facilitate billing
2. Communicates with facilities to obtain prior authorization information and/ or consent forms
3. Researches, identifies, and rectifies any special circumstances affecting delayed submission of insurance accounts or payment of accounts
4. Reviews insurance information loaded by registration staff for accuracy and completeness and identifies and/or rectifies problems

5. Supports staff by data entry of registration information and charge entry, and verification of insurance eligibility and benefits as needed
6. Remains informed of statutory and regulatory changes affecting collections of receivables
7. Provides information related to policy and procedure or instruction on the practice management system; Escalates issues and situations within the practice management system as necessary

Qualifications
Required Education: High school diploma or general education degree (GED)

Required Experience: 2 years’ experience with insurance billing requirements and account follow-up procedures including experience researching and resolving claims denied by insurance carriers, and a general understanding of ICD9 and CPT coding; or equivalent combination of education and experience.

Computer Skills Required: To perform this job successfully, an individual must have knowledge of general computer applications, including Excel and keyboarding experience, and practice management systems.

Physical Demands:
In order to successfully perform this job, with or without a reasonable accommodation, the following are outlined below:
1. The Employee is required to read, review, prepare and analyze written data and figures, using a PC or similar, and should possess visual acuity.

2. The Employee may be required to occasionally climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions.

3. The Employee is not substantially exposed to adverse environmental conditions and; therefore, job functions are typically performed under conditions such as those found within general office or administrative work.

INDSS