Insurance Follow Up Rep

About the role

You will resolve unpaid insurance claims and collect outstanding balances from third-party payers. Every day you will review denials, initiate follow-up with insurers, rectify billing errors, submit appeals, and negotiate for maximum reimbursement.

Responsibilities

• Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers.
• Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received.
• Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements.
• Resubmits claims with necessary information when requested through paper or electronic methods.
• Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify.
• Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels.

Requirements

• High School Graduate, upon hire or
• High School GED, upon hire
• Preferred: Other Graduation from a post-high school program in medical billing or other business-related field and Two years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities

Qualifications

• High School Graduate, upon hire or
• High School GED, upon hire
• Preferred: Other Graduation from a post-high school program in medical billing or other business-related field and Two years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities

Skills

• Understanding of billing regulations
• Strong problem-solving skills
• Effective communication skills

Benefits

• Comprehensive benefits package including medical, prescription drug, dental, vision, life insurance, paid time off, tuition reimbursement, retirement plan benefits, etc.

Pay

The posted compensation range of $16.42 - $23.19 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Schedule

Hours/Pay Period: 80
Weekly Schedule: M-F
Shift: Day
Remote: No