Professional Documents
Culture Documents
Experience
Atlantic Health System
Serve as a direct liaison for internal staff and PHX clients regarding claim matters and inquiries
Maintain awareness of and adhere to PHX/HIPAA compliance and privacy standards
Review claim reports and monitor turnaround time to ensure proper and timely handling of claims
Ensure all clients are serviced in the utmost professional manner while building exceptional and trusted
relationships with client contacts
Requesting insurance information such as patient responsibilities, DRG verification, PPO/R&C breakdown, payment
status, and precertification needed for claims processing.
Contacting healthcare providers to request and obtain medical and billing documents for claims processing.
Assisting nurse auditor in the medical claim audit process by requesting medical records needed from medical
providers nationwide
Utilize creative thinking skills to find alternate methods of retrieving medical documentation if records are not
available from the initial source
Recognizing medical records such as UB04, Itemized statements, operative reports, intra operative reports, cardiac
cauterization report, and implant records.
Skills