Job Title: Insurance Follow-Up Represtative
Location: Menomonee Falls, WI
Shift: Day 8 hour 8:00 am - 4:30 pm
Duration: 13 Weeks Contract

Submittal Requirements:

• High School diploma or equivalent
• Covid Card
• 2 Professional references from Last or Current Job.
• Two years of business office experience in billing, customer service, or collections in a healthcare environment is required.

Duties: 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 que light to ensure minimal wait times for patients in call que.
• 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.

Job Types: Full-time, Contract

Pay: $20.00 - $25.00 per hour

Schedule:

• 8 hour shift
• Day shift

Education:

• High school or equivalent (Preferred)

Experience:

• Billing, Customer Service, or collections in a healthcare: 1 year (Preferred)

Shift availability:

• Day Shift (Preferred)

Ability to Relocate:

• Menomonee Falls, WI: Relocate before starting work (Required)

Work Location: On the road