Insurance Follow Up Rep

3 weeks ago


Omaha Nebraska, United States CommonSpirit Health Full time
Overview:
REMOTE WORK OPPORTUNITY

 

Your time at work should be fulfilling. Rewarding. Inspiring. That’s what you’ll find when you join one of our non-profit CHI facilities across the nation. You’ll find challenging, rewarding work every day alongside people who have as much compassion as you. Join us and together we’ll create healthier, stronger communities.

CHI Health provides you with the same level of care you provide for others. We care about our employees’ well-being and offer benefits that complement work/life balance.

 

With you in mind, we offer the following benefits to support your work/life balance:

Health/Dental/Vision Insurance 

Direct Primary Plan (No copay, no deductible, and access to CHI Health provider 24/7)

Premium Access to our Family Care Program supporting your needs for childcare, pet care, and/or adult dependent care

Voluntary Protection: Group Accident, Critical Illness, and Identity Theft 

Employee Assistance Program (EAP) for you and your family

Paid Time Off (PTO) 

Tuition Assistance for career growth and development

Matching 401(k) and 457(b) Retirement Programs

Adoption Assistance

Wellness Programs

Flexible spending accounts

 

 

From primary to specialty care as well as walk-in and virtual services CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours.

Responsibilities:
ESSENTIAL KEY JOB RESPONSIBILITIES
1. Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is received.
2. Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received.
3. Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements.
4. Resubmits claims with necessary information when requested through paper or electronic methods.
5. Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify

6. Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels.

7. Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides.
8. Assists with unusual, complex or escalated issues as necessary.
9. Organizes open accounts by denial type or payer to quickly address in bulk with representatives over the phone, via spreadsheet, utilizing an on-line payer portal, etc.
10. Accurately documents patient accounts of all actions taken in billing system.
11. Other duties as assigned by leader and organization.

 

Qualifications:
QUALIFICATIONS

High School Diploma or equivalent required

Insurance Follow up Experience required

Graduation from a post-high school program in medical billing or other business related field is preferred

Two years of revenue cycle or related work experience preferred



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