Insurance Billing Follow-up Specialist

Insurance Billing Follow-up Specialist

7650 Revenue Cycle Management Schedule: Day Shift. 40 hours weekly. 8:00am – 5:00pm. Onsite

About the Position

This position performs day-to-day billing and follow-up activities within the revenue cycle operations. Responsible for ensuring assigned insurance balance does not age past filing deadlines based on payor’s specific requirements.

Overview of Responsibilities

• Verifies insurance coverage by investigation or interview.
• Follows up on accounts with insurance payers in a timely manner to avoid timely filing losses.
• Adds account notes in Epic as appropriate and per department expectations.
• Works an acceptable number of accounts based on department productivity standards.
• Utilizes telephone contacts, faxes, Internet, or other methods to follow up with payers.
• Reviews insurance credit balances and refunds payer when appropriate.
• Engages management when a claim is approaching the timely filing limit and is unsure how to get it paid or if the insurance/other responsible party is unresponsive.
• Requests and completes re-bills as necessary.
• Notifies management when payers are unresponsive.
• Responds to requests for information from patients or payers about claims or coverage.
• Actively participates in payer representative meetings to resolve issues.
• Follows compliance with laws, regulations, and guidelines of federal and state programs, emphasizing fraud, waste, and abuse prevention.
• Completes other duties and projects as assigned to support department goals.
• Actively participates in area and department meetings.
• Attends other meetings as requested.

• This list of duties and responsibilities is not intended to be all-inclusive and can be expanded to include other duties or responsibilities that management deems necessary.
• Education & E xperience

• Education Required: High School Diploma
• 2-3 years of experience in medical billing or insurance.
• Knowledge of government medical programs such as Medicare, Medicaid, Champus, etc., and the associated payment methodologies is preferred.