Remote Insurance Follow-Up Representative

This range is provided by Virtual Business Office Associates. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

$18.00/hr - $19.00/hr

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Position Overview

The purpose of this role is to support the organization by working simple to complex outstanding hospital and/or physician accounts receivable balances to resolution. This should be completed in a manner that meets productivity and quality standards. Research and account follow-up will be required to understand denials, or any other issues preventing payment, and to take the appropriate steps needed to resolve the account.

FLSA Status:
Non-Exempt

Job Responsibilities

? Performs all duties and responsibilities in accordance with local, state, and federal regulations and company policies.

? Utilize and apply industry knowledge to resolve new and aged accounts receivables by working various account types, including but not limited to: hospital and/or professional claims, governmental and/or non-governmental claims, denial claims, high priority accounts, high dollar accounts, reimbursements, credits, etc.

? Leverage available resources and systems (both internal and external) to analyze patient accounting information and take appropriate action for payment resolutions; document all activity in accordance with organizational and client policies.

? Communicate professionally (in all forms) with payer resources to include: websites/payer portals, e mail, telephone, customer service departments, etc.

? Maintain quality and productivity results at a level that meets departmental standards; as measured by a weekly average. More complex and aged accounts will be considered when criteria is set. Based on the complexity of the accounts worked the average could be subject to change.

? Reviews claims data and supporting documentation to identify coding and/or billing concerns.

? Ability to interpret payer contracts and identify contract variances affecting reimbursement.

? Utilize knowledge of the cash posting processing to obtain the necessary information to resolve misapplied payments.

? Demonstrate clear proficiency in third-party billing requirements to include: federal, state, and commercial/managed care payers.

? Interpret claim scrubber edits and takes appropriate action necessary to resolve issues.

? Seek resolution to problematic accounts and payment discrepancies.

? Prepare appeal letters for technical denials by accessing specific payer appeal forms, submitting appropriate medical documentation, and tracking appeal resolution.

? Analyze accounts with critical thinking; consider payer contracts and billing guidelines to ensure one touch resolution.

? Further responsibilities may include reviewing insurance credit balances to determine root cause and take the steps necessary to resolve the account.

? Identify denials trends, root cause, and A/R impact.

? Serve as a resource to other team members and assist Team Leads with identifying A/R and denials trends.

Job Requirements

? Must be 100% self-sufficient with the accounts worked, showing expertise and knowledge working independently to meet production and quality, while utilizing critical thinking and a solution-oriented mindset. Will need to have the ability to take initiative when needed to share trends with leadership.

? Possess thorough understanding of the hospital revenue cycle with specialization in hospital billing and/or physician billing, accounts receivable follow-up, and the account resolution process to include, but not limited to: claims submission, acceptance and adjudication, transaction reviews, adjustment posting, denials & appeals processes, identification of patient responsibility, etc. ? Demonstrate an ability to meet all established department/client quality and productivity standards.

? Proven track record with working complex AR accounts from billing to resolution.

? Experience working…