Transplant Insurance Follow-Up Specialist/Account Specialist

Job Description

Job Description

Job Title : Transplant Account Specialist

Reports to: Supervisor, Accounts Receivable

Summary: The Transplant account Specialist is responsible for performing follow up collections and denials resolution activity on open receivables for Global Transplant cases, acquisition, Transplant and post-transplant event claims. This position requires an advanced level of analytical collection skills and experience, understanding of global transplant billing, transplant phases, and transplant contracts. This position also requires complex organization, prioritization, problem solving and multitasking skills.

Essential Duties and Responsibilities:

• Works closely with multiple revenue cycle areas including Patient Access, Patient Accounting, Revenue Integrity, Coding, and Claims and Accounts Receivable departments to facilitate timely and accurate reimbursement for related professional services
• Responsible for tracking the notification, call for charges, collation of claims, billing, and reconciliation of global transplant bundles for professional claims.
• Routinely follows up on outstanding claim status and monitors open balances to proactively identify issues preventing or delaying payment
• Serves as a liaison with the UI Surgical Transplant Department Hospital Patient Accounting Office to verify patient and donor information and claims payment status.
• Coordinates with the Single Billing Office Customer Service team to resolve billing issues and questions for donors and recipients.
• Facilitates the timely disbursement of global transplant payments to UIPG through claim reconciliation and prompt communication to hospital Patient Accounts and MSP Finance.
• Tracks professional claim denials for transplant related services, identifies errors preventing payment and submits appeals to ensure appropriate reimbursement.
• Attends and actively participates in Transplant billing and reimbursement review meetings with revenue cycle leadership
• Maintains responsibility for assigned Epic FUWQ duties and established productivity/quality standards
• Other duties as assigned

Education/Experience :

High School Diploma or general Education Degree (GED) plus demonstrated expertise in transplant billing and global reimbursement methodologies. Minimum three years of experience in physician billing and directly related accounts follow-up collection methods and procedures. Must have applicable knowledge of medical terminology. Exceptional professionalism, written/verbal communication and strong customer service skills are essential. Must possess basic Microsoft Word, Outlook, and Excel skills. Previous Epic experience strongly preferred.

Knowledge, Skills & Abilities

• Knowledge – knowledge of medical terminology, revenue cycle and billing office procedures in physician billing is a must.
• Communication communicates clearly and concisely, verbally and in writing.
• Persistence – comfortable pursuing, rebutting and escalating issues as appropriate.
• Goal-oriented – holds him/herself accountable to achieving shared professional and personal goals.
• Customer orientation - establishes and maintains long-term internal customer relationships, building trust and respect by consistently meeting and exceeding expectations.
• Interpersonal skills – establishing and maintaining effective working relationships with employees, patients and external parties.
• PC skills - demonstrates high proficiency in Microsoft Office applications, especially Microsoft Excel, and others as required.
• Writing skills –advanced writing skills with ability to communicate concisely, punctuate properly, spell correctly and maintain professionalism.