Insurance Follow Up Rep

About the Role

The Chattanooga Heart Institute offers the most comprehensive cardiac care available in this region. Founded in 1976, we now have six offices in Tennessee and one in Georgia. Our practice includes 29 board-certified cardiologists, three cardiothoracic surgeons, and three vascular surgeons. We merged with CHI Memorial Health Care System in 2011, which is part of CommonSpirit Health, a network of over 700 care sites across the U.S. committed to building healthy communities.

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-offs, payments, refunds/recoups, and transfers when appropriate.
• Work insurance aging reports, review claims status, patient eligibility, and accuracy of account information; modify as needed to ensure proper and timely payment while maintaining A/R aging per company guidelines to maximize reimbursement.
• Submit patient claims, both paper and electronic, after corrections have been made or when re-billing is needed.
• Create appeal letters to submit to insurance carriers for timely payment.
• Review and reply (as needed) to all insurance correspondence, including assigned carrier newsletters and guidelines, and maintain a working knowledge of assigned carrier websites.
• 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.

Requirements

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

Pay

$16.42 - $23.19 per hour.