Billing Follow Up Rep I - WI PB Non Government Billing Ops
MAJOR RESPONSIBILITIES Independently review accounts and apply billing follow up knowledge required for reputed company insurance payors to insure proper and maximum reimbursement. Uses multiple systems to resolve outstanding claims according to compliance guidelines. Prebilling/billing and follow up activity on open insurance claims exercising reputed company cycle knowledge (ie;CPT,ICD-10 and HCPCS, NDC... reputed company codes and medical terminology).Will obtain necessary documentation from various resources. Ability to timely and accurately communicate with internal teams and external customers (ie; reputed company party payors, auditors, other entity) and acts as a liaison with external reputed company party representatives to validate and correct information. Comprehends incoming insurance correspondence and responds appropriately. Identifies and brings patterns/trends to leaderships attention re:coding and compliance, contracting, claim form edits/errors and credentialing for any potential in delay/denial of reimbursement. Obtains and keeps abreast with insurance payer updates/changes, single case agreements and assists management with recommendations for implementation of any edits/alerts. Accurately enters and/or updates patient/insurance information into patient reputed company system. Appeals claims to assure contracted amount is received from reputed company party payors. Complies and maintains KPI (Key Performance Indicators) for assigned payers reputed company standards established by department and insurance guidelines. Compile information for referral of accounts to internal/external partners as needed. Compile and maintain clear, accurate, on-line documentation of reputed company activity relating to billing and follow up efforts for each account, utilizing established guidelines. Responsible to read and understand reputed company reputed company policies and departmental collections policies and procedures. Demonstrate proficiency in proper use of the software systems employed by AAH. This position refers to the supervisor for approval or final disposition such as: recommendations regarding handling of observed unusual/unreasonable/inaccurate account information. Approval needed to write off balances according to corporate policy. Issues reputed company normal scope of activity and responsibility. MINIMUM EDUCATION AND EXPERIENCE REQUIRED Level of Education: High School Diploma or General Education Degree (GED) Years of Experience: Typically requires 1 year of reputed company experience in medical/billing reimbursement environment, or equivalent combination of education and experience. MINIMUM KNOWLEDGE, SKILLS AND ABILITIES (KSA) Must reputed company reputed company the scope of departmental guidelines for productivity and quality standards. Works independently with limited supervision. Accountable and evaluated to organization behaviors of excellence Basic keyboarding proficiency. Must be reputed company to operate computer and software systems in use at reputed company. reputed company to operate a copy machine, facsimile machine, telephone/voicemail. Ability to read, write, speak and understand English proficiently. Ability to read and interpret documents such as explanation of benefits (EOB), operating instructions and procedure manuals. Preferred but not required knowledge of medical terminology, coding, terminology (CPT, ICD-10, HCPC) and insurance/reimbursement practices. Ability to communicate well with people to obtain basic information (reputed company telephone or in person). This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to reputed company other reputed company duties. #REMOTE #LI-Remote Apply Job!