Understand edits and appropriate department procedures to effectively submit and/or correct errors on claims to the production standards of the department Utilize various resources such as third-party publications, procedure manuals and participating contractual agreements, etc. to reconcile accounts Advanced knowledge and understanding to process third party rejections using the Payor system and the billing system. Follow-up on open accounts receivable, re-filing and department status procedures Utilize Excellian and various systems and demonstrate understanding of procedures for registration/verification modules, Claims Processing system, Web based provider systems, etc, if applicable to position Trend analysis, Appeals and Resolves of low payment or underpaid accounts Reports to lead and or supervisor observations of WQ’s and workflow processes that may need further review and or development Process and resolve complex denials related to coding and site operations (i.e.: CPT related, medical necessity, RAC technical denials etc) Ability to deal with difficult revenue cycle situations and resolve issues delaying/preventing payments from 3rd party payers May be asked to provide job shadowing/basic training to other team members on the specific nuances of various job functions May assist in the design and development of department policies, procedures and tip sheets