Insurance Billing Follow-up Specialist
Summary
Processes insurance claims and follows up with payers to ensure timely payments and compliance, using systems like Epic in a healthcare revenue cycle role.
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 & Experience
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.