Insurance Follow-Up Representative
Job Description:
Our Westchester, NY-based client seeks two Temp-to-Perm Insurance Follow-Up Representatives.
Temp-to-Perm Insurance Follow-Up Representative Position Summary
Responsible for initiating follow-ups with third-party payers on outstanding accounts, reviewing insurance correspondence, and responding promptly. Responsible for supplying third-party payers with appropriate billing information to adjudicate a claim. Responsible for assuring appropriate payment was received in accordance with contract terms, reporting trends, and collaborating with denials and variance teams to ensure prompt and accurate payments. This position involves collecting and managing accounts, following up with insurance companies, reconciling accounts, filing corrected claims, and appealing claims when appropriate.
- Temp rate: Pay up to $30
- Perm Salary - $53 K - $80 K.
- Monday through Friday. For billing, the client would be open to a Sunday through Thursday schedule or a Tuesday through Saturday schedule.
- Hours are flexible, with options from 8 am-4 pm, 8:30 am-4:30 pm, and 9 am-5 pm.
Essential Functions and Responsibilities Include the Following:
1. Understands and adheres to the client’s Performance Standards, Policies, and Behaviors
2. Completes review of third-party outstanding balances and takes appropriate steps to resolve and reconcile outstanding balances
3. Processes patient and insurance refunds
4. Review open accounts for reconciliation and the next steps to resolve open balances
5. Review cases with the provider representative liaison to ensure escalation and processing of outstanding balances
6. Contact payors and patients as needed to resolve open balances and account issues
7. Responsible for reviewing assigned work queues and ensuring all accounts are worked promptly, especially high-dollar and aged accounts
8. Reviews correspondence for appropriate action to resolve accounts
9. Assure clear and concise notes within the EMR for all transactions
10. Completes associated actions within the EMR, such as insurance updates, adjustments, and allowances as needed
11. Escalates issues to management and provider representatives regarding incorrect payer processing, contract issues, and/or trends
12. Communicate with third-party representatives, relaying issues and discussing payment expectations
13. Take appropriate actions to resolve issues in a way that results in payment and/or complete closure of the insurance balance
14. Assure payor plan types and policy numbers are updated accurately within the EMR
15. Collaborates with teammates and vendors as needed to reconcile and resolve outstanding accounts
16. Review of claims to ensure payers process claims timely and according to contract provisions
17. Responsible for the timely completion of projects and tasks as assigned by management and providing feedback on outcomes
18. Responsible for ensuring productivity measures are being met daily
19. Performs all other related duties as assigned
Requirements:
Education & Experience Requirements- High School Graduate or GED required
- 2-5 years previous patient accounting and insurance follow-up experience (hospital), preferred
- Knowledge of medical terminology required
- Familiarity with electronic medical record system, EPIC preferred
- Proficiency with Microsoft Office/Excel to include PIVOTS and VLOOKUP, intermediate level required
- Must be detail-oriented, able to solve problems, multi-task, and perform various duties on demand
- Certified Patient Financial Services Specialist (CPFSS) certificate is required
- Effective 12/1/2022, the HBI (Healthcare Business Insights) one-time certification course is required and must be completed during the onboarding period and prior to the start date.
Please review the temp-to-perm Insurance Follow-Up Rep position and apply if you are interested in having your resume submitted.
