Þscription Responsible for ensuring unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and researches refunds. Monitors and ensures that collections, net, gross and days in accounts receivable targets are met. Responsibilities 1. Follows up on submitted claims, monitors unpaid claims and resubmits claims with appropriate corrections and documentation. 2. Works declines and processes appeals. 3. Responds to patient and third party inquiries; researches and resolves simple to moderately complex issues; corrects errors and refers complex issues to supervisor. 4. Reviews correspondence and rejection data from insurance carriers; posts rejections and performs reconciliations. 5. May transfer secondary balances to appropriate financial class and provides documentation for processing the claims. 6. Reviews Credit Letter Sent (CLS) and transfers balance to appropriate financial class and dunning level. 7. Reviews, works and clears electronic and claims edits daily; summarizes and forwards non-workable edits to supervisor for resolution. 8. May process refunds for supervisory approval. 9. Prepares and submits referring physician updates and other major dictionary requests to supervisor for approval. 10. Maintains strictest confidentiality; adheres to all HIPAA and Federal Payor guidelines/regulations. 11. Performs other related duties Qualifications Associates Degree or HS Diploma/GED plus two years of related experience. 2 years healthcare billing experience required. Familiarity with CPT and ICD (coding and CCI edits. Electronic claims processing preferred. Employer Description Strength through Unity and Inclusion The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai’s unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual. At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next chapter in our history. About the Mount Sinai Health System: Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high