With 150+ locations in 17 states, QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S. At QualDerm Partners, we are united in our purpose: to educate, protect, and care for your skin. We are committed to bringing you the very best in comprehensive skin care so that you can achieve a confident, healthier, and more beautiful you!
Our mission is to educate communities and healthcare professionals about the importance of skin health; including skin cancer prevention, risk factors and how to achieve healthy skin through annual skin exams and dermatologic care. We strive to provide the latest proven, proactive and comprehensive dermatologic care to populations in the expanding geographies we serve by making high-quality skin care timelier and more accessible all while creating a rewarding work environment for our providers and employees.
Purpose: Responsible for identifying and resolving third-party payer rejections. Will assist in resolution of edits/ errors that may result in nonpayment of charges or prevent charges from being accepted by payers. Also responsible for entering bills/charges with input from certified coding team when necessary.
Essential Duties and Responsibilities:
- Manage claims returned which have failed scrub rules
- Identify and resolve payer rejections in a timely manner.
- Enter charges/bills into EMR in coordination with certified coding team/Coding manager
- Monitor missing charges and communicate with RCM management as needed
- Must have knowledge of claim correction, electronic claim submission
- Ability to contact payers when necessary to resolve any issues
- Report any trends in a timely manner to RCM leadership that prevent successful claim submission
- Ability to effectively communicate with other departments such as Coding, AR/Follow-up, Patient Services and Posting
