Specialist Follow Up

Billing Representative

This position is responsible for accurate and timely billing of assigned accounts, along with the follow-up of these accounts to ensure prompt payment. Responsibilities also include staying current with all Payer rules and regulations to ensure proper billing and compliance. The representative is responsible for prompt follow-up with third party payors and maintaining quality standards. The individual pursues and ensures timely and accurate expected reimbursement collection for the hospital, interpreting managed care contracts and holding payors accountable to contract standards. Demonstrate respect, dignity, kindness and empathy in each encounter with all patients, families, visitors and other employees regardless of cultural background.

Follow-Up Responsibilities

• Call insurance or use online payer portals for status on claims
• Records appropriately detailed notes in Epic
• Takes appropriate action to resolve claims : write disputes, communicates with supervisor / lead
• Coordinates and provides feedback in payer meetings to discuss payer trends and issues
• Meets productivity and quality standards
• Demonstrates excellent customer service skills when interacting with patients to resolve claim issues (i.e. COB, Accident Details)
• Demonstrates adequate, appropriate, and professional levels of communication with insurance company representatives, team members, supervisors, and managers
• Collaborates with Technical Denials Specialists to track, trend, and resolve claim issues
• Work insurance correspondence and inbound faxes timely and makes the necessary responses to the letters received
• Ensures timely turnaround of internal requests (EOB's, medical records) through effective follow-up
• Elevates serious barriers to claim resolution to the leadership team

Billing Responsibilities

Other

Communication / Trending

Continuing Education & Training

Education, Credentials, Licenses :

Specialized Knowledge :

Kind and Length of Experience :

FLSA Status : Non-Exempt

Right Career. Right Here. If you're looking for the right careers in healthcare, the right place to be is at St. Elizabeth. Join us, and you'll take pride in the level of care we offer our community.