Responsible for ensuring that all assigned third-party accounts are reviewed and that all payers remit payment in a timely manner. Ensures all eligible accounts are appealed within the designated payer timeframes and documented appropriately in the patient accounting system. Coordinates the transfer and communication of accounts with insurance balances to the appropriate outside agency.
Reviews aging reports or work lists in hospital related billing system(s) to identify accounts in need of follow up. Drafts and submit letters and reports in accordance with departmental policy and procedures. Monitors payments for accuracy and timeliness and reports ongoing issues to Supervisor. Ensures claims are crossed over to secondary insurances, reporting any delay in unbilled secondary claims. Responsible for meeting account targets, error ratios, and reporting requirements. Monitors month-end metrics and baseline variances and provides explanations to leadership when appropriate.
Resolves claim edit errors and issues identified in the Claim Edit work queues, tracks and trends and inform Manager/Supervisor.

Commercial Follow Up Rep