Offer summary

Qualifications:

Strong communication skills and experience in insurance follow-up., Knowledge of hospital billing and insurance claim processes., Ability to manage multiple patient accounts efficiently., Educational background in healthcare administration or related field preferred..

Key responsibilities:

Follow up on hospital patient accounts with outstanding insurance payments.

Communicate with insurance companies to resolve payment issues.

Research and route patient accounts through appropriate workflows.

Aim to resolve accounts to a zero balance or escalate to patient responsibility.

Job description

Timely follow-up on hospital patient accounts that are outstanding for insurance payment, including but not limited to the following processes: verify claim payment status, rebill to patient’s insurance, proration to correct financial class and notation within patient accounts providing steps taken to resolve outstanding insurance balance on account.
Work an average of 30-40 patient accounts per workday for assigned payor(s)
Manages an average of 30-40 patient accounts per day, focusing on denial and zero-pay reporting.
Assigned Payor denials and Zero ($0) pay reports worked within 48 hours of receipt
Communicate effectively with insurance companies for payment of outstanding insurance balances, understanding of next steps needed to reach resolution of outstanding insurance balance
Perform research on patient accounts with outstanding insurance balances and route patient accounts through appropriate workflows
Responsible for resolving patient accounts with outstanding insurance claims to a zero balance or advancing them to the patient responsibility financial class.
Performs account follow-up on unpaid or partially paid insurance claims for hospital services.
Contacts insurance payors through various methods, including telephone calls, Insurance payor web portals, E-faxing, email
Investigates the cause of non-payment towards outstanding hospital claims and takes appropriate actions such as: Requesting insurance companies to process claims, requesting cash posting review for corrections, initiating coding reviews for account resolution, contacting patient for insurance information
Completes adjustment requests for Team Lead approval if an adjustment to the outstanding balance
Submits requests for claim rebilling when additional information is required, using either a shared spreadsheet or the EHR system. Utilizes MEDTEAM’s ticketing system to submit claim inquiry requests if additional information or review from the hospital is required.

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