Essential Duties and Responsibilities:
- Responsible for all aspects of insurance follow up and collections, including making telephone calls, accessing payer websites.
- May maintain a large dollar inventory desk as well as serve as just-in-time staffing, working inventory for team members that may be absent or backlogged.
- Effectively resolve complex or aged inventory, including payment research, payment recoups with minimal or no assistance necessary.
- Accurately and thoroughly document the pertinent collection activity performed.
- Review the account information and necessary system applications to determine the next appropriate work activity.
- Verify claims adjudication utilizing appropriate resources and applications. Initiate telephone or letter contact to patients to obtain additional information as needed.
- Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers.
- Edit claims to meet and satisfy billing compliance guidelines for electronic submission.
- Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory.
- Proactively identify issues or trending and provide suggestions for resolution.
- Provide assistance, coaching and training to staff members, including new hires.
- Provide enhanced training and assist staff with techniques to increase production, quality and collections. Participate in the new hire peer interviewing process.
- Assist in special projects assigned by management.
- Participate and attend meetings, training seminars and in-services to develop job knowledge. Attend various conference calls, webinars or advanced training to provide assistance to the team members.
- Respond timely to emails and telephone messages from the staff, management and the client.
- Effectively communicate issues to management, including payer, system or escalated account issues as well as develop solutions.
Minimum Education/Licensures/Qualifications:
- HS/Diploma GED equivalent
- 1+ years of Medical Insurance collections (Hospital highly preferred)
- Must have strong follow up experience
- Follow Up service is designed to increase Revenue Collection for Hospitals and Physician offices. The process begins after the Doctor’s biller creates and sends Health Insurance Claims (Electronic/ Paper claims or Manual HCFA forms) to various Insurance companies. Depending on the transmission type and length of time since submission we begin our follow-up:
Electronic Claims: Follow-Up begins 10+ days after submission
Paper/HCFA Claims: Follow-Up begins 20-45 days after submission
Advantages of this Opportunity:
- Competitive salary, negotiable based on relevant experience
- Benefits offered, Medical, Dental, and Vision
- Fun and positive work environment
- Monday-Friday must be available from 8:00AM to 5:00PM hour shift.
