City of Baltimore, Mayor's Office of Employment Development

• →Completes timely claim submission, denial management, payment variance, and accounts receivable resolution.
• →Imports, edits, corrects and transmits hospital claims on a daily basis.
• →Ensures activity is fully documented related to claim submission, follow-up and resolution in hospital systems.
• →Investigates and/or refers to management systemic billing issues that cause delays in reimbursement.
• →Identifies administrative denials by working denial work-items and through remittances; follows through with appeal or corrective action to obtain claim payment.
• →Applies payor acceptance reports and 277 reports to manage payor rejections and take appropriate action for resolution.
• →Applies appropriate HOLDS and subsequently releases claims based on billing requirements, coding needs and data deficiency.

******************************************************************************************************************************************