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Insurance Follow-up Specialist - Lincoln, United States - BryanLGH Medical Center
Description
GENERAL SUMMARY:
The Insurance Follow-up Specialist is responsible for timely, efficient and accurate follow-up on outstanding insurance and credit balances.
In addition to insurance follow-up, this role is responsible for completing any reworks, re-submissions, reconsiderations, appeals or claim communications timely and according to the requirements of the payer.
The Insurance Follow-up Specialist answers questions from payers, departmental staff, other outside agencies, patients or family verbally, through the mail or via phone as needed.
#PRINCIPAL JOB FUNCTIONS:
1.#*Commits to the mission, vision, beliefs and consistently demonstrates our core values.
2.#*Performs follow-up on all outstanding claims and takes the appropriate action to ensure timely and accurate# reimbursement following the payers filing guidelines 3.#Reviews and analyzes all claims for correct and complete patient and insurance information, service dates, and charges.
4.#*Makes outbound calls to payers and accesses payer websites. 5.#*Maintains knowledge of current billing guidelines and third party payer regulations. 6.#*Investigates reason for errors by communicating with specified department personnel and makes the necessary corrections within system. 7.#Actively researches State and Federal regulations and billing guidelines to stay current to ensure compliance. 8.#*Contacts patients or employers as necessary for correct health plan information by calling or sending correspondence as needed. 9.#*Responds to all inquiries, billing rejections, and other correspondence and phone requests in an efficient and effective manner. 10.#*Completes reconsiderations and appeals as needed. 11.#Works with the appropriated department concerning any coding issues or reviews. 12.#Follows Medical Center protocols in communicating and releasing patient information. 13.#Documents all activities on accounts in the hospital patient accounting system. 14.#Identifies issues or trends with accounts and makes suggestions for possible resolutions. 15.#Works closely with the Hospital Billing Specialists to resubmit claims and resolve errors as needed. 16.#Performs other related projects and duties as assigned. (Essential Job functions are marked with an asterisk #*#. Refer to the Job Description Guide for the definition of essential and non-essential job functions.) Attach Addendum for positions with slightly different roles or work-specific differences as needed.EDUCATION AND EXPERIENCE:
High school diploma or equivalency required.# Associates degree in business or accounting related field preferred.
One (1) year of experience in a healthcare setting, preferably working in billing, insurance follow-up or accounting required.# Training or prior experience in CPT/ICD-10 coding desired.# Must be at least 19 years of age to witness legal consents.
#GENERAL SUMMARY:
The Insurance Follow-up Specialist is responsible for timely, efficient and accurate follow-up on outstanding insurance and credit balances.
In addition to insurance follow-up, this role is responsible for completing any reworks, re-submissions, reconsiderations, appeals or claim communications timely and according to the requirements of the payer.
The Insurance Follow-up Specialist answers questions from payers, departmental staff, other outside agencies, patients or family verbally, through the mail or via phone as needed.
PRINCIPAL JOB FUNCTIONS:
1. *Commits to the mission, vision, beliefs and consistently demonstrates our core values.
2. *Performs follow-up on all outstanding claims and takes the appropriate action to ensure timely and accurate reimbursement following the payers filing guidelines
5. *Maintains knowledge of current billing guidelines and third party payer regulations.
6. *Investigates reason for errors by communicating with specified department personnel and makes the necessary corrections within system.
9. *Responds to all inquiries, billing rejections, and other correspondence and phone requests in an efficient and effective manner.
10. *Completes reconsiderations and appeals as needed.
EDUCATION AND EXPERIENCE:
High school diploma or equivalency required. Associates degree in business or accounting related field preferred. One (1) year of experience in a healthcare setting, preferably working in billing, insurance follow-up or accounting required. Training or prior experience in CPT/ICD-10 coding desired. Must be at least 19 years of age to witness legal consents.
