General Summary of Duties: This position is responsible for following up on claims from billing through final resolution. Other responsibilities include:
Essential Functions: Core duties include the following, but are not limited to:
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Work denied and unpaid accounts receivable from insurance on a daily basis to secure payment.
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Call insurance companies and utilize insurance websites to obtain claim status.
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Actively follow up and collect on paper and electronic claims from insurance companies and follow up on unpaid balances.
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Identify and correct billing errors and resubmit to insurance carriers while ensuring corrected claims and appeals are sent out to insurance companies timely (timely filing).
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Follow protocol related to write offs and adjustments policies.
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Identify denials trends and develop solutions to reduce denials and increase payments.
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Actively manage all Insurance AR processes for assigned accounts, monitoring trends and notifying the appropriate staff.
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Keep on task to meet all required deadlines and time-frames for customer and company needs.
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Assist in the development of processes and procedures for accounts receivable as needed.
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Respond to all insurance questions regarding AR.
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Ensure compliance with all relevant regulations, standards, and laws
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Respond/answer tasks, email and phone calls from insurance companies, staff, and management
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Report and participate in company meetings, as requested
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Process patient payments over the phone and answer patient phone calls, as needed
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Process insurance refund requests and work insurance credits as needed
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Acting cooperatively and courteously with patients, visitors, insurance companies, co-workers, physicians and management.
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Able to provide extraordinary customer service to all parties interacted with.
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Other duties as assigned by management.
Educational Minimum Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
- High School Diploma or GED required
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3 years of experience in specialty insurance collections, including submitting and following up on claims
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Experience in Physician Billing and Collections / Facility Billing
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Proficiency with MS Office
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Familiarity with ICD terms