Insurance Follow-Up Specialist

3 weeks ago


Houston, United States The Menninger Clinic Full time
Job DescriptionJob Description

Hours/Days: M-F, 8 am to 5 pm. Position is hybrid.


Key Functions

Manages the processing of commercial claims through account resolution.

  1. Work with third party carriers to obtain eligibility and out of pocket expenses.
  2. Monitors claim status via telephone, internet, and/or fax.
  3. Review and interpret contractual terms and explanation of benefits.
  4. Identify and post contractual adjustments, third party payments, and out of pocket remittances.
  5. Set up, maintain, and edit payment arrangements on patient accounts, as necessary.
  6. Monitor and resolve delinquent accounts through the organization’s collections process.
  7. Processes credit balances and overpayments.

Maintains knowledge of information and functionality.

  1. Observes all HIPAA required practices including, but not limited to, maintaining HIPAA compliance and confidentiality for all patient and clinic information.
  2. Maintains knowledge of computer system functions as it pertains to Patient Accounts.
  3. Enters patient demographics, insurance information, charges, and adjustments to Outpatient accounts.

Provides administrative services for patients; assist staff members, as needed.

  1. Assist Outpatient Administrative positions and functions, as needed.
  2. Schedule patient appointments for Outpatient visits.
  3. Assist clinicians with proper CPT coding selections.

Assist with other Revenue Cycle projects and other duties as requested.

  1. Accepts additional assignments willingly.
  2. Demonstrates an ability to respond to changing workloads.
  3. Assists Utilization Review with initial authorizations and concurrent reviews.


EDUCATION Required: High school diploma or equivalent required. Associates degree in business or related field preferred.

License/Certification
Medical Billing certificate, CRCR, CRCS, CHAA PREFERRED

Experience Required: Two years of Revenue Cycle and hospital experience. Knowledge of Microsoft Office, including Word, Excel, and Outlook.



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