25508827 - Insurance Follow-Up Rep | Jobs with Virtelligence

25508827 - Insurance Follow-Up Rep Cancelled

Location: Wisconsin Country: United States
Theresa Enderyas

Theresa Enderyas is recruiting this position.

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Job Description

  • Responsible for researching and resolving all unpaid insurance claims and following up on all customer inquiries/complaints related to unpaid balances.

Other duties as assigned.
  • Answers patient calls and researches and responds to patient concerns within 24 working hours.
  • Maintains knowledge of complex reimbursement methodologies in Managed Care contracts including DRG, per diem, per visit, fee schedule and surgical group methodologies.
  • Applies knowledge for accurate resolution of claims within contract terms.
  • Uses knowledge of hospital policy, department procedures, Wisconsin Uniform Billing Regulations (UB04 Manual), HMO/PPO agreements and other contractual arrangements to maintain accounts receivable, manage commercial payors, and manage appeals.
  • Serves as back-up to person primary on taking incoming calls. Monitors que light to ensure minimal wait times for patients in call que.
  • Identifies denial trends and reports issues to Insurance Follow-up Coordinator/Insurance Follow-up Supervisor for escalation with payer liaisons
  • Participates in cross-training efforts for specific systems based on goals set by the PFS department.
  • Addresses accounts qualifying to workstation within one week utilizing system specific follow up procedures.
  • Coordinates efforts with ancillary departments as needed in a timely manner for effective resolution.
  • Updates new insurance information received on an account to reflect accurate insurance plan coding to ensure accurate statements are mailed to patients.
  • Uses transaction codes specific to each system and links those to UB 1500 bills and agreements to process follow-up functions.
  • Updates and verifies payor specific account information.

  • Two years of business office experience in billing, customer service, or collections in a healthcare environment is required.

  • High School diploma or equivalent is required.
  • Status:
  • Skills

    Business Office Experience In Billing: 2 years