Submitting clean claims to insurance payers electronically (EDI) or on paper using standardized forms like the CMS-1500. Recording payments received from payers and patients.

Review and appeal denied or underpaid claims.Identify and categorize denials, correct and rebill, communicate with provider, front desk, and coder, File an appeal if needed, educate and denial prevention.

Investigating and appealing denied or underpaid claims.

Use providers' cloud-based PMS, EMR, ERA that supports claims submission, payment posting, denial management, records and reporting.

Ensuring all billing practices adhere to HIPAA regulations and other relevant healthcare laws. 

Translating medical procedures and diagnoses into universal codes, such as CPT, HCPCS and ICD-10 codes.

Collecting, verifying patient demographic information and insurance details.

Mailing patients' billing statements, Appointment Reminder Cards and Patient Collection Letters when needed.

Credentialing is the process of verifying a provider's qualifications, including education, training, licenses, and certifications. 

Enrollment (or payer enrollment/contracting) is the subsequent process of registering the verified provider with specific insurance networks (Medicare, Medicaid, and commercial insurers like Aetna, Cigna, etc.) to establish a formal agreement for payment of services.

Insurance verification is the process of confirming a person's insurance coverage is valid, active, and meets necessary requirements.