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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:
Schedule Days Per Week: 5.00
Schedule Hours Per Week: 40.00
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.
- 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.
- High School Diploma or equivalent.
- Two years of business office experience in billing, customer service, or collections in a healthcare environment.
- OFFICE EXPERIENCE
- CUSTOMER SERVICE
- CLAIMS
- BILLING
- MANAGED CARE
- COLLECTIONS
- CONTRACTS
- INCOMING CALLS
- RETAIL SALES
- CREDIT SCORES
- CODING
- CREDIT TASKS
- CUSTOMER SERVICE ORIENTED
- AUTO INSURANCE
- PFS
- CUSTOMER INQUIRIES
- CREDIT ISSUES
- English( Speak, Read, Write).
Schedule Days Per Week: 5.00
Schedule Hours Per Week: 40.00
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