Insurance Follow Up Rep

Job Summary

Responsible for follow up of insurance to include: claims submitted, appeal processes and inquiries; monthly accounts receivable reports to ensure timely and maximum reimbursement from assigned insurance carriers.

Essential Responsibilities

• Field patient and insurance calls regarding patient account receivables.
• Audit patient accounts for accuracy regarding charges, payments, demographics, insurance information and filing to ensure contractual agreements are being met.
• Request adjustments, write-off, payment, refunds/recoups, and transfers when appropriate.
• Work insurance aging reports, review claims status, patient eligibility, accuracy of account information and modify as needed to ensure proper and timely payment while maintaining A/R aging per company guidelines to maximize reimbursement.
• Create appeal letters to submit to insurance carrier for timely payment.
• Review and reply (as needed) to all insurance correspondence, including assigned carrier newsletters and guidelines as well as maintain a working knowledge of assigned carrier website.
• Maintain current knowledge of insurance guidelines through newsletters and websites.
• Assist with demographic/charge entry and capture of all hospital charges.
• Work in all areas of the department during peak times, vacations, illnesses, etc.

Job Requirements

• Education: High school diploma or equivalent; some college preferred.
• Qualifications: Two or more years in health insurance processing; medical office experience preferred.