Account Follow-up Specialist II

About the role

In the complex web of health care insurance and claims, you are a calm, organized problem-solver. With your advanced knowledge of the multi-payor system, you resolve delinquent payment issues. Your ability to communicate clearly, collaborate with others and maintain respect for all parties involved reflects the Legacy mission.

Responsibilities

• Resolves delinquent payment issues of complex (high dollar and specialty) accounts requiring advanced knowledge of multi-payor system.
• Investigates and evaluates patient account information, medical records and bills, billing and reimbursement regulations.
• Analyzes each account using independent judgment deciding how to best proceed with follow up to optimize reimbursement.
• Removes barriers to processing claims.
• Rebills, transfers payments, requests refunds and or adjusts misapplied payments as necessary.
• Understands and follows Legacy procedures for writing off balances and adjustments.
• Submits reconsiderations and or appeals as appropriate for denied claims.

Qualifications

Education: High school graduate or equivalent.

Experience: Two years of directly applicable healthcare business office experience (billing/credit/collection) required.

Skills

• Demonstrates problem-solving and decision-making skills.
• Understands complex collection issues for UB04's and CMS-1500 claims.
• Knowledge of multi-payor systems.
• Knowledge of billing/collection rules and regulations.
• Knowledge of online systems for eligibility and status review of claims.
• Familiarity with billing software and electronic medical records including Microsoft suite products and 10 key proficiency.
• Knowledge of medical terminology.
• Ability to resolve billing issues and handle denied claims.
• Ability to work efficiently with minimal supervision, exercising independent judgment within stated guidelines.
• Demonstrated effective interpersonal skills which promote cooperation and teamwork.
• Ability to withstand varying job pressures and organize/prioritize related job tasks.
• Excellent verbal and written communication skills.
• Ability to adapt to change.

Pay

USD $22.32 - USD $31.90 /Hr.