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Insurance Billing Follow-up Specialist @ Reidhealth

North ComplexOnsiteFull-time
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About this role

Insurance Billing Follow-up Specialist 7650 Revenue Cycle ManagementSchedule: Day Shift. 40 hours weekly. 8:00am – 5:00pm. Onsite

About the Position This position performs day-to-day billing and follow-up activities within the revenue cycle operations. Responsible for ensuring assigned insurance balance does not age past filing deadlines based on payor’s specific requirements.

Overview of Responsibilities

• Verifies insurance coverage by investigation or interview.

• Follows up on accounts with insurance payers in a timely manner to avoid timely filing losses.

• Adds account notes in Epic as appropriate and per department expectations.

• Works an acceptable number of accounts based on department productivity standards.

• Utilizes telephone contacts, faxes, Internet, or other methods to follow up with payers.

• Reviews insurance credit balances and refunds payer when appropriate.

• Engages management when a claim is approaching the timely filing limit and is unsure how to get it paid or if the insurance/other responsible party is unresponsive.

• Requests and completes re-bills as necessary.

• Notifies management when payers are unresponsive.

• Responds to requests for information from patients or payers about claims or coverage.

• Actively participates in payer representative meetings to resolve issues.

• Follows compliance with laws, regulations, and guidelines of federal and state programs, emphasizing fraud, waste, and abuse prevention.

• Completes other duties and projects as assigned to support department goals.

• Actively participates in area and department meetings.

• Attends other meetings as requested.

This list of duties and responsibilities is not intended to be all-inclusive and can be expanded to include other duties or responsibilities that management deems necessary.

Education & Experience

• Education Required: High School Diploma

• 2-3 years of experience in medical billing or insurance.

• Knowledge of government medical programs such as Medicare, Medicaid, Champus, etc., and the associated payment methodologies is preferred.

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