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Insurance Follow-Up Rep

Careers Integrated Resources Inc Menomonee Falls, WI (Onsite) Contractor
Job Title: Insurance Follow-Up Rep
Job Location: Menomonee Falls, WI
Job Duration: 3-4 Months(possibility to extension)
Shift: Monday - Friday 8 hour shifts Shift start times between 7:00am - 9:00am

Job Summary:
  • Responsible for researching and resolving all unpaid insurance claims and following up on all customer inquiries/complaints related to unpaid balances.
  • Other duties as assigned.
Duties and Responsibilities:
  • Answers patient calls and researches and responds to patient concerns within 24 working hours.
  • Maintains knowledge of complex reimbursement methodologies in Managed Care contracts including DRG, per diem, per visit, fee schedule and surgical group methodologies.
  • Applies knowledge for accurate resolution of claims within contract terms. 
  • Uses knowledge of hospital policy, department procedures, Wisconsin Uniform Billing Regulations (UB04 Mannual), HMO/PPO agreements and other contractual arrangements to maintain accounts receivable, manage commercial payors, and manage appeals.
  • Serves as back-up to person primary on taking incoming calls.
  • Monitors queue light to ensure minimal wait times for patients in call queue.
  • Identifies denial trends and reports issues to Insurance Follow-up Coordinator/Insurance Follow-up Supervisor for escalation with payer liaisons.
  • Participates in cross-training efforts for specific systems based on goals set by the PFS department.
  • Addresses accounts qualifying to workstation within one week utilizing system specific follow up procedures.
  • Coordinates efforts with ancillary departments as needed in a timely manner for effective resolution.
  • Updates new insurance information received on an account to reflect accurate insurance plan coding to ensure accurate statements are mailed to patients.
  • Uses transaction codes specific to each system and links those to UB 1500 bills and agreements to process follow-up functions.
  • Updates and verifies payor specific account information.
Required Education:
  • High School Diploma or equivalent.
Required Skills & Experience:
  • Two years of business office experience in billing, customer service, or collections in a healthcare environment. 
  • OFFICE EXPERIENCE
  • CUSTOMER SERVICE
  • CLAIMS
  • BILLING
  • MANAGED CARE
Additional Skills:
  • COLLECTIONS
  • CONTRACTS
  • INCOMING CALLS
  • RETAIL SALES
  • CREDIT SCORES
  • CODING
  • CREDIT TASKS
  • CUSTOMER SERVICE ORIENTED
  • AUTO INSURANCE
  • PFS
  • CUSTOMER INQUIRIES
  • CREDIT ISSUES
Languages:
  • English( Speak, Read, Write).
Schedule Hours Per Day: 8.00
Schedule Days Per Week: 5.00
Schedule Hours Per Week: 40.00
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Job Snapshot

Employee Type

Contractor

Location

Menomonee Falls, WI (Onsite)

Job Type

Insurance

Experience

Not Specified

Date Posted

04/02/2025

Job ID

25-42799

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