Managed Care Follow Up Representative

Job Title: Managed Care Follow Up Representative

Position Summary: Reporting to the Hospital RRC Supervisor/Manager, the Managed Care Follow Up Representative is responsible for reviewing assigned third-party and patient accounts, ensuring timely billing to responsible payers, documenting account status accurately, and identifying and escalating complex issues to leadership. This role requires expertise in patient accounting systems, knowledge of third-party operations, and effective communication with stakeholders.

Skills:

• Proficiency in various patient accounting systems and associated applications.
• Strong understanding of third-party operations and reimbursement structures.
• Knowledgeable in medical terminology, CPT, HCPCS, and ICD-10 coding.
• Ability to work independently and multitask in a high-stress environment while maintaining attention to detail.
• Excellent customer service skills for effective communication with payers, patients, and colleagues.
• Strong oral and written communication skills.
• Professional conduct and ability to foster good working relationships.

Performance Responsibilities:

• Review hospital accounts to determine appropriate actions for revenue cycle progression, including initiating phone calls, submitting inquiries, and recommending adjustments, all in accordance with department policies.
• Meet or exceed productivity and quality standards as per department policies.
• Conduct root cause analyses on accounts, track trends, and escalate issues to leadership.
• Participate in projects and audits, collecting financial documents and collaborating with internal departments, external vendors, and IT for issue resolution.
• Regularly meet with Team Lead/Supervisor to discuss billing obstacles, reimbursement issues, and process improvements.
• Monitor accounts for timely filing guidelines, ensure claims compliance, and resolve billing errors promptly.
• Assess payments and adjustments for accuracy, review payer reimbursement systems/contracts, and report ongoing issues to management.
• Promote positive patient experiences and satisfaction.
• Adhere to all organizational policies and procedures.

Selling Points:

• Opportunity for permanent placement in a large organization.
• Temporary position with potential for long-term employment.

Must-Have Skills/Qualifications:

• Experience with Epic is preferred.
• Background in hospital-side collections and billing is advantageous.

Schedule/Shift:

• Monday-Friday
• Flexible shift timings: 7:30 AM - 3:30 PM / 8:00 AM - 4:00 PM / 8:30 AM - 4:30 PM / 9:00 AM - 5:00 PM (choose one and adhere to it)
• Initially fully onsite; potential for hybrid work model upon permanent placement, with one day per pay period (every two weeks) in the office.

Pay: $22-$27/hr

Apply Now!