Claims Follow Up Rep

Responsibilities

• Review all denied claims (primary, secondary, tertiary), correct them in the system and send corrected/appealed claims to third party payers to result in reimbursement for services performed.
• Resolve all outstanding claims (whether the payer has responded or not), underpaid claims, and overpaid claims.
• Identify and analyze denials and enact corrective measures as needed to effectively communicate and resolve errors and ensure timely and accurate reimbursement.
• Understand and maintain compliance with HIPAA guidelines when handling patient information.
• Contact internal departments/patients to acquire missing or erroneous information on a claim.
• Identify denial trends resulting in revenue delay and report to supervisor.
• Follow department policies and procedures pertaining to workflows, assignments, and adjustments.
• Contact third party payers and answer their inquiries.
• Retrieve appropriate medical record documentation based on third party requests.
• Research payer policies and ensure claims meet those payer policies.
• Thoroughly master the nuances of assigned specialties.
• Perform other related duties as required.

Qualifications

• BASIC KNOWLEDGE:
• Equivalent to a high school graduate.
• Knowledge of third party billing, including 1500 claim forms, CPT, and ICD-10.
• Excellent verbal and written communication skills.
• Technical proficiencies to include Microsoft Excel, Outlook, and Teams applications.
• Demonstrated problem-solving skills.
• EXPERIENCE:
• One to three years of relevant experience in insurance follow-up of professional/hospital billing.
• Experience with Epic preferred.

Benefits

Not specified.

Pay

$19.97-$32.96

Schedule

7:30 am - 4:00 pm

Working Conditions

Position can be fully remote, hybrid, or in-office. Manager will approve work arrangements.