Actively track and follow up on aging Certificates of Medical Necessity and Assignment of Benefits forms to reduce unbilled revenue.? Document actions taken during the course of follow up on CMNs and any additional paperwork.? Log signed and returned CMNs.? Accurately resolve and address problems encountered during the follow up process.
- Contact (outbound phone calls) physician?s offices to check the status of outstanding forms (CMN, LMN, Medical Records) that are required before products can be shipped.
- Generate documents to send to physicians and patients, resending existing documentation, and logging documentation.
- Contact patients (outbound phone calls) to discuss Advanced Beneficiary Notice (ABN) requirements and to follow up on unsigned documents.
- Create documents required based on payer guidelines and submit them to the designated physician. Review medical records to determine if they meet the necessary criteria and log into the system.
- Receive inbound call volume that can include patient questions, physician information updates, patient complaints, etc.
- Identify incorrect patient information and work with the physician and patient to bring the problem to a resolution.
- Handle questions coming from internal teams and sales, through phone and email, on order statuses.
- Communicate any ongoing documentation issues related to a physician or referral to the applicable sales representative.
- Closely monitor and update the billing system ? including the Patient, Doctor, Referral, Supporting Documentation and Billing Files.
- Communicate any issues encountered during the documentation retrieval process to the Team Lead and/or Department Manager
1+ years' claims examiner experienceCritical Skills
- Excellent communication skills ? ability to handle both inbound/outbound calls and email correspondences
- Ability to multi-task ? providing timely follow up on orders and ensuring accuracy with all required medical documentation
- Intermediate level in MS Excel & Outlook
- Prior medical and insurance industry experience ? ability to translate medical records preferred
- Knowledge of ICD-10, HCPCS and CPT coding preferred
- Brightree knowledge preferred
HS Diploma or EquivalentPhysical Requirements
Professional office environment ? this position requires availability Monday ? Friday from 8:30am ? 5:00pm EST
McKesson is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.Qualified applicants will not be disqualified from consideration for employment based upon criminal history.McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to . Resumes or CVs submitted to this email box will not be accepted.Current employees must apply through internal career site.Join us at McKesson!