Account Follow-up Specialist (Medical)

Job Description

Title: Patient Account Follow-Up Specialist
Reports to: Billing Office Manager
Classification: Full-Time, Non-exempt

Position Summary. The Patient Account Follow-Up Specialist acts as a functional resource to all departments within the organization by managing account follow-up for all assigned accounts, resolving billing problems and answering patient inquires. The Patient Account Follow-Up Specialist maintains insurance accounts receivables within the aging guidelines set by the company.

Responsibilities:

• Perform audits of patient accounts to ensure accuracy and timely payment.
• Review account agings on a monthly basis and reports inconsistencies; corrects errors as appropriate.
• Contact patients any insurance issues where the patient needs to rectify and update system with demographic corrections as discovered.
• Follow up on insurance billing to ensure timely receipt of payments.
• Demonstrate the ability to deal with patients and insurance companies regarding sensitive financial matters and recapture unpaid balances.
• Initiate adjustment as necessary; follows up on all zero payment explanations of benefits and exercises all options to obtain claim payments.
• Review credit balance reports for correct recipient of refund.
• Contact insurance payor’s who can remit deduct overpayment and initiate process with thirty days of the overpayment.
• Perform reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks.
• Identify problems on accounts and follows through to conclusion.
• Identify and retrieve all documentation and prepares appeals for management as needed.
• Respond to insurance companies requests for information in a prompt and professional manner.
• Review EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends to supervisor.
• Resubmit insurance claims for both electronic rejections and secondary payors within 24 hours of receipt. Electronic audit report and secondary claims are to be pulled and printed daily.
• Notify Manager of any changes or discrepancies in Payor Manuals/Profiles.
• Seek drug replacement and all avenues of reimbursement before deeming and account a write off.
• Prepare write-off requests with appropriate documentation and submits to supervisor.
• Process insurance correspondence, including denial follow-up within 24 to 48 hours of receipt. Process all reimbursement correspondence daily.
• Work with provided aging report and runs system aging reports to monitor insurance accounts aging and follows up appropriately.
• Remain abreast of industry changes and insurance updates.
• Pull charges into daily batch PM system.
• Meet as scheduled with management and physicians to review outstanding accounts receivables.
• Function as back-up as needed by management for all other positions within the billing office.
• Maintain confidentiality in regards to patient account status and the financial affairs of clinic/corporation.

NECESSARY SKILLS, QUALIFICATIONS, AND PERSONAL QUALITIES:

• High school diploma or GED.
• Minimum of 3 years experience in medical business office setting with insurance processing and balancing responsibilities.
• Literate in Windows environment including Microsoft Word, Office, Outlook, and Excel.
• Literate in the Electronic Medical Records software used by the practice.
• Able to perform basic mathematics.
• Knowledge of medical billing, and insurance processes.
• Knowledge of insurance agency operating procedures and practices.
• Knowledge of governmental, legal and regulatory provisions related to collection activities.
• Proficiency in CPT and ICD9, and IDC10 coding.
• Ability to understand and follow oral and written communication
• Knowledge of medical terminology
• Able to operate printer, scanner, copier, facsimile, credit card machine, computer, telephone, calculator.
• Maintain strict confidentiality.

WORKING CONDITIONS

While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle, or feel objects, office equipment, medical equipment, or controls; reach with hands and arms; and talk and hear; periodically carry cumbersome items such as records and supplies. The noise level in the work environment is usually moderate.

Job Type: Full-time

Pay: $18.00 - $21.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• Accounts Receivable: 3 years (Required)

Work Location: In person

Salary : $18 - $21