Insurance Follow Up Representative

Schedule/Shift
Monday - Friday: either 8-4/830-430/9-5 , open to candidates taking any shift but wants them to stick with it (occasional one offs of taking a different shift for appts, ect. is fine)

Overview:
-Performs follow up on all outstanding accounts assigned in accordance with established standards and procedures.
- Determines reason for denial and appeals accounts as necessary.
- Reviews and edits any rejections stemming from electronic billing submissions and corrects and resubmits claims.
- Verifies accuracy of patient insurance and demographic information.
- Generates bills to patients for services not covered by insurance.
- Investigates over-payments and takes appropriate action to resolve. Initiates refund requests in accordance with departmental procedures.
- Responds to requests for information and telephone inquiries from patients, insurance carriers, and outside agencies in a courteous manner.
- Send secondary claims to appropriate payors.

Selling Points:

-Large org, room for growth

-Weekly Pay

-Benefits

-PTO

3-5 Must Have Skills/Qualifications
- High School diploma or equivalent required.
- Strong knowledge of medical insurance and healthcare billing
- Establishes and demonstrates competency in accounts receivable systems and associated applications
- Ability to communicate effectively with insurance carriers, patients, and co-workers
- Ability to comply with procedural guidelines and instructions and to solicit assistance when
situations arise that deviate from the norm.

- Excellent verbal and auditory skills are required
for communicating with internal staff, customers and representatives from external departments and agencies.
- Minimum of 3 years of Physician Billing experience, including insurance carrier follow up and customer service, required.

Nice to Have Skills
Consistency in resume, not job hoppy

metrics: productivity metrics, depending on insurance - for commercial payers 12 claims per hour, govt 17 claims per hour - 80% of goal is standard

75% of work on portals, definitely times on the phone as well

calling just insurances, not patients

Open to backgrounds working with both types of insurances

Epic preferred not required

ideal background: ideally 3 years of follow up experience - working denials and receivables

3 years firm - potentially flexible on the 3 years as a minimum but needs strong follow up experience

-Open to a hospital billing background as well