Medical Claims / Eligibility & Payment… at Software… · Nashville

Processing all medical services bills received on eligibility clients including but not limited to:
o verification of client eligibility
o ensuring payer of last resort status
o keying invoices in PTBMIS to authorize payment.
o status checks of payment processing as needed.

• Assisting with the payment denials process including but not limited to:

o correspondence with vendor.
o maintenance of internal tracking spreadsheet.
o internal processes to complete recoupment process.

• Assisting with maintaining and distributing an updated Fee Schedule document of services covered under Ryan White Part B.
• Assisting with the annual Authorization to Vendor process.
• Assisting with the processing of client eligibility applications in RWES.