Insurance Follow-Up Specialist - Professional Billing
|Owensboro Health Business Center
||Hours: 8a - 4:30p (M - F)
- Manages account receivables by preparing and submitting claims to insurance carriers, posting insurance and patient payments, performing follow up with insurance carriers on unpaid, rejected or denied claims and answering patient inquiries on account status and charges. Completes less routine assignments. Duties and tasks are more complex. Exercises judgment to solve more complex problems.
- Enters information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information. Insures claim information is complete and accurate.
- Submits insurance claims to clearing house or individual insurance companies electronically or via paper.
- Follows up with insurance companies for unpaid or rejected claims. Communicates with payors and other necessary contacts to resolve the issue and re-submit claims as needed.
- Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to accompany the appeal.
- Prepares and submits secondary claims upon processing by the primary insurer.
- Posts insurance and patient payments via electronic remit posting or manual posting.
- Answers patients' questions on patient responsible portions, co-pays, deductibles, write-offs, etc. Resolves patient complaints or explains why certain services are not covered.
- Prepares and reviews routine billing reports to ensure timely and accurate billing activity. Recommends process improvements based on findings.
- Adheres to all organizational policies and procedures. Executes all tasks and behaves in a manner consistent with a culture of compliance, safety, and a high-reliability organization; behavior supports the organization's core commitments of Integrity, Service, Respect, Teamwork, Excellence, and Innovation.
- High school diploma or General Equivalency Diploma (GED) required. Associate's degree in related field preferred.
- 2 to 8 years progressive experience in a related field required.
Skills & Attributes
- Applies more advanced skills and knowledge in the area of specialization. Requires critical thinking skills and decisive judgment. Works under general supervision. Must be able to work in a stressful environment and take appropriate action.
- This description is intended to describe the general nature and level of work performed by employees assigned to this position. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees. Specific duties and responsibilities consistent with the general nature and level of work described may vary by department and additional related duties may be assigned as needed. Some duties listed may not apply to all areas.
Additional Position Related Details Populations Served Training is provided relevant to the population served, based on the scope of care of the service assignment.
Activity & Frequency:
- Bending/Stooping - Never
- Climbing - Never
- Keyboard Data Entry - Frequently
- Kneeling - Never
- Lifting/Moving Patients - Never
- Lifting/Carrying (Non-Patient) - 0-25 lbs - Never
- Lifting/Carrying (Non-Patient) - 25-75 lbs - Never
- Lifting/Carrying (Non-Patient) - over 75 lbs - Never
- Pushing/Pulling - 0-25 lbs - Never
- Pushing/Pulling - 25-75 lbs - Never
- Pushing/Pulling - over 75 lbs - Never
- Reaching - Frequently
- Repetitive Foot/Leg Movements - Never
- Repetitive Hand/Arm Movements - Frequently
- Running - Never
- Sitting - Frequently
- Squatting - Never
- Standing - Frequently
- Walking - Frequently
- Audible Speech - Frequently
- Hearing Acuity - Frequently
- Smelling Acuity - Never
- Taste Discrimination - Never
- Vision: Depth Perception - Frequently
- Vision: Distinguish Color - Frequently
- Vision: Seeing - Far - Frequently
- Vision: Seeing - Near - Frequently
- Owensboro Health is committed to providing a safe working environment including training and access to person protective equipment necessary to this position. While performing duties of this position, occupational exposure to bloodborne pathogens is present for all employees.