Professional Billing - Omaha, NE

Only for registered members Omaha, NE, United States

1 month ago

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Job summary

The Insurance Follow-up Specialist is responsible for corresponding with commercial or government insurance payers to address and resolve outstanding insurance balances and denials in accordance with established standards guidelines and requirements. Conducts follow-up process activities through phone calls online processing fax and written correspondence leveraging work queues to organize work efficiently.

Responsibilities

  • Follow up on insurance or government claims to research and resolve unpaid claim and denials in follow-up work queues by contacting payers and/or patients for status.
  • Responsible for obtaining reimbursement information when payment and remit are both provided via paper. Communicate effectively over the phone and through written correspondence to explain why a balance is outstanding and denied using accurate supported reasoning based on EOBs medical records payer specific requirements. Resubmit claims with necessary information medical records when requested by payer through paper electronic methods ensure payments from third party payors Organize open accounts denial type payer quickly address bulk representatives over the phone spreadsheet utilizing an on-line payer portal etc Apply thorough understanding interpretation Explanation of Benefits EOBs remittance advices Accurately documents patient accounts all actions taken system Responsible resolving work according prescribed priority direction management department expectations Recognize additional assistance needed resolve escalates appropriately timely defined communication escalation channels

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