What are the responsibilities and job description for the Insurance Follow Up Representative position at TEKsystems?
*Description*
Responsible for ensuring correct and timely reimbursement from third party payors for services provided by Anesthesiology group. The Collections Rep will appeal, re-bill, and perform other necessary actions to collect revenue. The Collections Rep will be involved in other AR related projects on a daily basis. The Collections Rep will employ appropriate resources to investigate, analyze, identify and reduce barriers to correct adjudication, such as issues involving Network Set-Up, Fee Schedules, Denial Management, and Contract Compliance. The primary focus of this position is to maximize reimbursements through the timely follow up of accounts.
- Proven working experience as a Collections/Account Receivable Rep
- Solid understanding of insurance follow-up, denials, reimbursements, contracts and insurance policies
- Investigate Accounts identified as low pays, denials, or otherwise (75%)
* Review accounts in work file/queue and take appropriate steps to resolve accounts in compliance with contracts, agreements, or appropriate measures.
* Contact insurance company/third parties by telephone, letter, fax, e-mail, etc. as needed.
* Include complete and appropriate comments on actions taken to resolve accounts.
* Review and perform analysis and trending to identify possible barriers to correct and timely claim submission, claim processing, provider enrollment, among others which may result in non-payments, delayed payments, or low payments.
* Transfer accounts when necessary and only after confirming updated registration or eligibility.
* Ensure that all claim submissions, appeals, and requested information is provided within the required time frame to avoid timely filing issues and processing delays.
* Properly handle all other insurance explanation of benefits that require other activities or reconciliation.
* Request and include correct and appropriate attachments as required and in accordance with policies and procedures.
* Assist with special projects, audits and reconciliation as necessary.-
- Reconcile credit balances and submit requests for refunds in accordance with policies or when applicable or contact Payor to initiate off-sets/retractions of incorrectly paid services when possible. (15%)
- Investigate and submit for approval write off allowances and/or adjustments that have reasonable justification in accordance with contracts and policies. (10%)
- Interact professionally and productively with Co-workers and staff in areas such as registration, Physician Billing, and Patient Access and Revenue Cycle, and others.
- Meet minimum production and performance target goals.
- Work correspondence daily.
*Additional Skills & Qualifications*
Needs someone with min 2 years ideally 5-7 years of insurance follow-up, AR collection, denial management for commercial and government payors. Anesthesia experience is preferred. EPIC experience is necessary.
Knowledge of word processing, electronic mail, and spreadsheet applications.
* Must be proficient in Microsoft Excel. Must be comfortable working with large data sets.
* Excellent analytic skills.
* Excellent interpersonal and organization skills.
* Ability to handle multiple tasks, meet deadlines and handle confidential materials.
* Excellent phone etiquette. Strong customer service and phone skills.
*Pay and Benefits*
The pay range for this position is $20.00 - $21.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
* Medical, dental & vision
* Critical Illness, Accident, and Hospital
* 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
* Life Insurance (Voluntary Life & AD&D for the employee and dependents)
* Short and long-term disability
* Health Spending Account (HSA)
* Transportation benefits
* Employee Assistance Program
* Time Off/Leave (PTO, Vacation or Sick Leave)
*Workplace Type*
This is a fully onsite position in Philadelphia,PA.
*Application Deadline*
This position is anticipated to close on Apr 24, 2025.
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Responsible for ensuring correct and timely reimbursement from third party payors for services provided by Anesthesiology group. The Collections Rep will appeal, re-bill, and perform other necessary actions to collect revenue. The Collections Rep will be involved in other AR related projects on a daily basis. The Collections Rep will employ appropriate resources to investigate, analyze, identify and reduce barriers to correct adjudication, such as issues involving Network Set-Up, Fee Schedules, Denial Management, and Contract Compliance. The primary focus of this position is to maximize reimbursements through the timely follow up of accounts.
- Proven working experience as a Collections/Account Receivable Rep
- Solid understanding of insurance follow-up, denials, reimbursements, contracts and insurance policies
- Investigate Accounts identified as low pays, denials, or otherwise (75%)
* Review accounts in work file/queue and take appropriate steps to resolve accounts in compliance with contracts, agreements, or appropriate measures.
* Contact insurance company/third parties by telephone, letter, fax, e-mail, etc. as needed.
* Include complete and appropriate comments on actions taken to resolve accounts.
* Review and perform analysis and trending to identify possible barriers to correct and timely claim submission, claim processing, provider enrollment, among others which may result in non-payments, delayed payments, or low payments.
* Transfer accounts when necessary and only after confirming updated registration or eligibility.
* Ensure that all claim submissions, appeals, and requested information is provided within the required time frame to avoid timely filing issues and processing delays.
* Properly handle all other insurance explanation of benefits that require other activities or reconciliation.
* Request and include correct and appropriate attachments as required and in accordance with policies and procedures.
* Assist with special projects, audits and reconciliation as necessary.-
- Reconcile credit balances and submit requests for refunds in accordance with policies or when applicable or contact Payor to initiate off-sets/retractions of incorrectly paid services when possible. (15%)
- Investigate and submit for approval write off allowances and/or adjustments that have reasonable justification in accordance with contracts and policies. (10%)
- Interact professionally and productively with Co-workers and staff in areas such as registration, Physician Billing, and Patient Access and Revenue Cycle, and others.
- Meet minimum production and performance target goals.
- Work correspondence daily.
*Additional Skills & Qualifications*
Needs someone with min 2 years ideally 5-7 years of insurance follow-up, AR collection, denial management for commercial and government payors. Anesthesia experience is preferred. EPIC experience is necessary.
Knowledge of word processing, electronic mail, and spreadsheet applications.
* Must be proficient in Microsoft Excel. Must be comfortable working with large data sets.
* Excellent analytic skills.
* Excellent interpersonal and organization skills.
* Ability to handle multiple tasks, meet deadlines and handle confidential materials.
* Excellent phone etiquette. Strong customer service and phone skills.
*Pay and Benefits*
The pay range for this position is $20.00 - $21.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
* Medical, dental & vision
* Critical Illness, Accident, and Hospital
* 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
* Life Insurance (Voluntary Life & AD&D for the employee and dependents)
* Short and long-term disability
* Health Spending Account (HSA)
* Transportation benefits
* Employee Assistance Program
* Time Off/Leave (PTO, Vacation or Sick Leave)
*Workplace Type*
This is a fully onsite position in Philadelphia,PA.
*Application Deadline*
This position is anticipated to close on Apr 24, 2025.
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Salary : $20 - $21
