Learn how to expedite claims and appeals and get paid. Gain confidence that you are securing correct payments from commercial carriers and receive tips to avoid common claims processing errors.
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Up to 90% of revenue in a healthcare provider's practice flows through third-party payers. How much of it is hanging in limbo due to denials? Make sure that your dollars are flowing in the right direction. Spend less time fighting denials and more time ensuring that your front end details are in order. The window to appeal a denied claim is shrinking. Learn how to expedite claims and appeals and get paid. This program provides an overview of health insurance plans and payment models and tips on how to avoid common claims processing errors. Updated for 2023
MHL, CMC, CMCO, CMIS, CMOM, CMCA E/M
Jan Hailey has more than 30 years of experience in healthcare. She is proficient in administration, coding, and billing roles, and teaches medical office professionals around the country how to excel in their careers. Jan has also been instrumental in the development of PMI's Workforce Initiatives program.
Jan's affinity for teaching has helped countless healthcare providers and medical office professionals over the years. During her expansive career, she has served as Director of Quality for Saint Joseph Physician Network located in Mishawaka, IN, and Director of Care Management with Select Health Network, an entity of Saint Joseph Health System. As Care Management Director, Jan led the physician network and comprehensive interdisciplinary team across the health system working closely with providers, management, staff, community, and payers to develop strategies for process improvement, gap closures, and patient experience. She developed a documentation improvement program and a Hierarchical Condition Category (HCC) coding education program to predict future healthcare utilization by accurately reporting patient complexity.
Prior to joining Saint Joseph, Jan was the Director of Quality, Coding, and Compliance for one of the largest health systems in Northern Indiana. She has a Master of Health Leadership and four professional certifications in office management, coding, insurance processing, and compliance. She is a member of WPS Government Health Administrators (Medicare) Provider Outreach and Advisory Group.
This training is appropriate for health insurance claims processors with limited experience. Medical coders, practice managers, providers, clinical staff and consultants seeking a better understanding of the overall reimbursement process may also benefit.
The content covered in this course assumes a basic understanding of insurance claims processing. No supplementary materials are required for this course.
Self-paced online program includes unlimited review of previously recorded instruction and the downloadable course materials for 6 months.
Comments from past participants:
“I think this was an excellent beginner course. There was a large amount of very good information and it was well presented.”
“The instructor was wonderful. Very insightful and the information presented was extremely helpful.”