Patient Account Rep/Follow-Up

Insurance Claims Follow-Up Specialist

Responsible for timely and effective followup on insurance claims. Also responsible for billing efficiently to third party payers when needed.

Responsibilities

• Is responsible for filing insurance claims for all third party payers. Addresses any edits pertaining to billing correctly and accurately, reports repetitive edits to management for system correction.
• Processes credit balances and issues refund requests where appropriate. Analyzes daily electronic billing reports for errors. Identifies claims with errors preventing acceptance and corrects and rebills these accounts. Performs daily reconciliation of claim submission and receipt
• Proactively addresses problems and issues encountered in billing or follow-up in order to resolve accounts in a timely manner.
• Follows up on unpaid or denied claims. Actively works on assigned queues incorporating high dollar report and denial queue into the followup activity.
• Stays informed of all rules and regulations governing billing and reimbursement of 3rd party payors. Utilizes tools available from each payors including; websites, payor meetings, educational seminars and provider reps.
• Promotes/portrays a high level of professionalism, both technically and personally. Possesses strong work ethic and exhibits optimism. Adheres to the departmental dress code policy, maintaining a professional appearance and positive attitude.
• Promotes positive relationships among co-workers. Communicates effectively within the department and keeps management informed on key issues.
• Performs other duties as assigned.

Qualifications/Requirements

Experience

• 1-3 yrs. office experience, preferably in medical related field or equivalent education.

Education

• High School diploma