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    Follow Up Specialist - Springfield, United States - Memorial Health University Medical Center

    Memorial Health University Medical Center
    Memorial Health University Medical Center Springfield, United States

    4 days ago

    Default job background
    Description
    Overview:
    • Follows up on outstanding payments due on different types of open medical insurance claims.
    • Coordinates activities with external insurance companies to resolve patient account balances.
    • Ensures compliance with managed care guidelines and organizational policies.
    • Embodies the Memorial Health System Performance Excellence Standards.
    Qualifications:
    • Education: Education equivalent to completion of high school or GED is required.
    • Experience: Two or more years as an Account Follow-Up Specialist or similar experience in medical insurance or health care billing is necessary.
    Other Knowledge/Skills/Abilities:
    • Demonstrates thorough knowledge of electronic billing systems, medical terminology, and coding.
    • Understands contract management systems and insurance guidelines.
    • Basic working knowledge of personal computers and Microsoft Office products preferred.
    • Ability to work within managed care contract policies and procedures.
    • Excellent communication and problem-solving skills required.
    Responsibilities:
    • Accesses insurance providers' websites to verify patient insurance eligibility.
    • Examines patient accounts to identify further actions needed.
    • Investigates and resolves incomplete or incorrect patient account information.
    • Follows up on unpaid items and contacts for prompt payment.
    • Researches and resolves insurance claim denials and underpayments.
    • Analyzes reports on rejected account information and provides necessary research.
    • Responds to internal requests on coding and processing medical insurance claims.
    • Communicates and resolves issues with various internal and external parties.
    • Performs necessary corrections and calculations for charges and write-offs.
    • Documents online systems accurately for claim status and payment tracking.
    • Ensures compliance with managed care guidelines for accurate reimbursements.
    • May assist with special projects or audits.
    • Performs additional related tasks as needed.
    The aim of this job description is to give a summary of the key duties and responsibilities. Incumbents may be required to perform tasks beyond those outlined.
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