Under the supervision of the Business Office Supervisor, the Insurance Follow-Up Representative is responsible for physician billing and collecting of third-party account receivables using their knowledge of medical software, the EHR, and multiple payors’ insurance websites to research accounts, refile or appeal claims, submit additional medical documentation and track account status by monitoring and analyzing assigned unresolved third-party accounts. The Representative is responsible for an inventory of over a $1M in insurance receivables. They will initiate contacts and negotiate appropriate resolution (internal and external) as well as receive and resolve inquiries and correspondence from third parties and patients. The ability to analyze, audit, problem solve and reconcile an account is critical to this position. Conducts duties in accordance with industry federal and state billing guidelines and contractual obligations and in compliance with department policies and procedures. Must demonstrate dependability and an ability to work independently. Must be able to retain composure, meet deadlines, and appropriately analyze, research, and resolve problems in a fast-paced environment with constant work-related interruptions. Professionalism and courtesy are expected when communicating with external contacts and patients to explain patient financial liability, advises of non-coverage, process payments and payment plans, clarify Explanation of Benefits and statement of physician services. Exhibits exceptional customer skills to provide the patient with a positive service experience.
Job Title: Insurance Follow Up Representative II
Clinic Location: Pearland Administration Office Building
Department: Business Office
Job Type: Full Time
Salary Range: $41,059.00 – $50,710.00 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
Required: High School diploma or GED from an accredited program
Preferred: Associates degree in Business Administration or related field; or successful completion of Coding and Billing Certificate Program.
Required: Requires 3 or more years current experience in a health care billing and collection environment or relevant health care setting using an accounting/health care computer system; or 2 years of related experience with preferred education.
Preferred: 5 years of experience in a health care billing and collection environment or relative health care setting using an accounting/health care computer
system in area of specialty. Epic Professional Billing experience a definite plus as is an understanding of a diversity of insurance plans.
Required: Basic PC and Internet literacy. Medical Terminology, CPT & ICD coding application. Interpreting Explanation of Benefits (EOB’s), physician billing statements. Good analytical and mathematical ability.
Preferred: Epic Professional Billing. Ability to access and retrieve information from the EHR.
Required: Excellent interpersonal communications skills and ability to communicate effectively both orally and in writing with patients, physicians, management, and third-party representatives. Ability to handle a variety of tasks with speed, attention to detail and accuracy. Working knowledge of major third-party payers and their websites.
Working Environment: Office
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