SHS-BILLING FOLLOW-UP SPECIALIST

Billing Follow-Up Specialist

Positions Location: East Lansing, MI

Job Description

General Purpose of Job: A Billing Follow-Up Specialist is responsible for accurate and timely follow-up for assigned denied or unpaid accounts. This role ensures prompt, accurate reimbursement for services rendered by appealing denials, correcting claims, and working diligently with payers to resolve outstanding balances.

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis. Team members may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Conduct follow-up on unpaid or denied claims to ensure timely and accurate reimbursement.
• Analyze denial reasons and take appropriate action to appeal or resubmit claims.
• Contact payers and utilize online portals to resolve outstanding account balances.
• Collaborate with billing, coding and clinical staff to gather necessary documentation for appeals or corrections.
• Track and document follow-up activities in Epic in compliance with department policies.
• Quickly identify and solve problems, escalating recurring denial trends or payer issues to team leaders when necessary.
• Responsible to validate the payments and adjustments made on accounts are correct.
• Maintains daily work queues according to work queue prioritization guidelines.
• Maintain quality and productivity standards and participate in team meetings to discuss recurring issues.
• Knowledge of payer guidelines, including utilization of payer websites and other tools.
• Performs other duties as assigned. These may include but are not limited to: Maintaining a current knowledge base of department processes, protocols and procedures, pursuing self-directed learning and continuing education opportunities, and participating in committees, task forces, and work groups as determined by management.

Job Requirements

General Requirements: EPIC or Revenue Cycle Certification preferred.

Work Experience: 1-2 years of experience in healthcare collections, claims follow up, or denial management.

Education: High school diploma or GED.

Specialized Knowledge and Skills: Ability to work independently with minimal supervision. Detail-oriented with strong problem-solving and communication skills. Proficiency with computer functions, including ability to use automated systems for third party billing and insurance follow up. Professional, business-like appearance and demeanor. Recognizes and reports problems, errors and discrepancies to management. Shares information with co-workers. Ability to contribute to team efforts. Ability to assist with training of new employees as needed.