Insurance Follow-up Agent

Description

Meet and/or exceed production standards and monthly revenue/billing goals  

Position Summary:  

The job of the Recovery Specialist (insurance billing and collections) is to reconcile aged receivable accounts to determine where the outstanding balance lies.  Once that is determined, the Recovery Specialist will then need to take the appropriate action; whether that be contact the insurance company for a reprocess, submit a reprint/rebill or appeal to the insurance, submit for the appropriate write off/adjustment, and/or close out the remaining balance to patient responsibility.

Tasks and Responsibilities:

• Investigate/Reconcile outstanding accounts to determine the cause for the remaining balance
• Make insurance calls to resolve the outstanding account balance and obtain any pertinent information regarding the outstanding claim
• Resubmit reprints, rebills, and/or appeals to the insurance for processing
• Identify and submit any needed contractual adjustments or other write-offs
• Identify remaining patient responsibility, close out the balance to the patient

PM20

Requirements

Education/Experience/Skills Required:

Education

• High school diploma or GED equivalent.

Skills

• Strong communication skills
• Medical terminology
• Insurance contract experience
• Medical billing/claim generation experience
• Understanding of UB04 and HCFA1500 forms
• Strong mathematics
• Basic Microsoft Office knowledge
• The ability to Multitask
• Excellent customer service
• Practice effective written and oral communication
• Experience in Cerner billing system a plus!

Functional Experience

• Organization
• Time Management
• Stick to client specific processes and procedures
• The ability to handle multiple computer systems at one time
• Creative talk offs, effective negotiation skills and proper follow up habits
• Compliance with HIPAA, FCRA, FDCPA and all other applicable laws and regulations

Attributes:

• Dependable
• Effective listening skills
• Organized and the ability to multitask
• Fast learner and the ability to troubleshoot
• Properly handle highly confidential information

Physical Requirements:

While performing the duties of this job, the employee is frequently required to use their hands to type; regularly required to sit for extended periods of time, talk, hear and read; occasionally required to walk and reach with hands and arms.  The employee is occasionally required to lift and/or move up to 25 pounds.  Special vision requirements for this job include close vision and ability to adjust focus.  The noise level in the work environment is usually moderate.  This position may require some reimbursable travel.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.