EPN Billing Followup Rep, Full Time, Days

Job Summary

Responsibilities

• Processes and validates claims via electronic submission or other acceptable payer specific methods.
• Initiates follow up procedures on unpaid claims within defined timeline to ensure timely payment is received.
• Reviews various reports/work queues and identifies rejected or denied claims making appropriate corrections.
• Communicates repetitive or unusual errors to manager and/or others to resolve problematic actions or activities which may be user or system driven affecting clean claim accuracy.
• Utilizes Patient Management System applications appropriately as trained to gain maximum efficiency while billing and conducting follow up of patient accounts.
• Responds to payer requests for additional information timely in order to facilitate claim processing and payment.
• Reviews payer specific remittances to analyze and make corrections in order to re-bill/appeal or internally adjudicate claims in response to denials.
• Utilizes knowledge and experience to ensure appropriate reimbursement is obtained and appropriate adjustments are processed.
• Processes transaction adjustments as may be necessary as supported by remittance documentation.
• Processes payment posting timely electronic and manually as necessary.
• Applies notes to individual patient accounts that are informative, concise and facilitates corrected account resolution.
• Review and process credit balances as appropriate to insurance or guarantor.
• Answer patient calls and discuss patient balances. Take payments and set up appropriate payment plans.

Qualifications

• Education: High School Diploma, GED required. Medical billing certification desirable.
• Experience: Minimum of one year working experience in professional/hospital insurance billing, collections and payment posting processes with a clear understanding of insurance reimbursement principles.
• Computer literacy with basic skills in patient account management systems, Microsoft Suite, particularly Excel and Word as well as various web-based applications.