Insurance Follow-up Specialist

Revenue Cycle- Account Reimbursement Specialist II Job Summary: The Account Reimbursement Specialist I (ARS I) is responsible for accurately processing information to ensure accurate and compliant billing for office and hospital procedures. The Revenue Cycle – ARS I researches insurance guidelines and focuses on improving the effectiveness of billing processes. The position requires attention to detail, strong organizational skills, and dependability. This role is vital to the overall financial success for the organization. (This is a full time position that will support our RCM team at SouthPark Monday to Friday, 8 am to 5 pm) Primary Job Responsibilities: Performs daily billing activities to ensure successful processing and payment of claimsEnsures claim information is complete and accurate for charge entry and data enters key demographic information necessary for insurance claim processingVerifies all patient benefits, eligibility, and coverage to ensure accurate billingAudits completeness and accuracy of all claims prior to submission to claims clearinghouseMake necessary claim corrections to resolve payer claim edits and rejectionsReports billing changes, billing issues, and process improvement plan accomplishments to RCM LeadershipCompletes tasks in RCM to resolve patient cases (via phone or written communication), process virtual payments, process insurance refund requests, research missing payments, process bankruptcy and deceased patient notifications, and collection account reconciliationEnsures compliance with all Health Insurance Portability and Accountability Act (HIPAA) standardsPerforms other duties as required or assigned within the scope of responsibility Requirements: Minimum of two (2) years of complex claim follow-up experience in a physician office, hospital, ambulatory surgery center or centralized medical business officeKnowledge of medical terminology, ICD-10, and CPT codes. Excellent computer skills; Intermediate skill with Microsoft Word, Outlook, and Excel. Experience working within EMR systems. Experience with AthenaHealth EMR is a plus. Experience interpreting payor explanation of benefits. Excellent verbal communication skills and strong customer-service backgroundAbility to manage time and organize daily schedule to meet productivity and accuracy standards. Education and Certifications: High school diploma or equivalent requiredAssociate degree in business, healthcare administration or related field highly preferred. Physical Requirements: Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pullingMust be able to lift and support weight of 35 pounds. Ability to concentrate on detailsUse of computer for long periods of time