Billing Follow-Up Specialist - PB * Days (M-F, 8a-5p)- 40hr/wk

General Purpose Of Job

A Professional Billing Follow-Up Specialist is responsible for accurate and timely follow-up for assigned denied or unpaid accounts. This role ensures prompt, accurate reimbursement for services rendered by appealing denials, correcting claims, and working diligently with payers to resolve outstanding balances.

Education

• High school diploma or GED
• EPIC or Revenue Cycle Certification preferred

Experience

• 1-2 years of experience in healthcare collections, claims follow up, or denial management

Skills & Abilities

• Detail-oriented with strong problem-solving and communication skills
• Proficiency with computer functions, including ability to use automated systems for third party billing and insurance follow up
• Professional, business-like appearance and demeanor
• Recognizes and reports problems, errors and discrepancies to management
• Shares information with co-workers
• Ability to contribute to team efforts
• Ability to assist with training of new employees as needed

Essential Duties

• Conduct follow-up on unpaid or denied claims to ensure timely and accurate reimbursement
• Analyze denial reasons and take appropriate action to appeal or resubmit claims
• Contact payers and utilize online portals to resolve outstanding account balances
• Collaborate with billing, coding and clinical staff to gather necessary documentation for appeals or corrections
• Track and document follow-up activities in Epic in compliance with department policies
• Quickly identify and solve problems, escalating recurring denial trends or payer issues to team leaders when necessary
• Responsible to validate the payments and adjustments made on accounts are correct
• Maintains daily work queues according to work queue prioritization guidelines
• Maintains quality and productivity standards and participate in team meetings to discuss recurring issues
• Knowledge of payer guidelines, including utilization of payer websites and other tools

Additional Duties

• Maintains a current knowledge base of department processes, protocols and procedures
• Pursues self-directed learning and continuing education opportunities
• Participates in committees, task forces, and work groups as determined by management