Cognizant Technology Solutions is seeking an Insurance Follow-up Specialist to work for one of its clients in Warrensville Heights, OH.
The Insurance Follow-up Specialist is responsible for hospital and physician billing and collecting. The duties include working with payers to resolve issues and facilitate prompt payment of claims. This position is highly focused on the resolution of insurance processing errors and denials. Payers include but are not limited to: Medicare, Medicaid, Blue Cross, and commercial health insurance carriers.
Duties and Responsibilities include the following and any other duties as assigned by the supervisor:
Verifying of health insurance benefits to ensure coverage and eligibility prior to claims submission
Follow-up regarding claim status
Identifying and resolving any and all outstanding issues preventing claim resolution
Ensure all required statements have been sent on accounts handled and request statements as necessary.
Properly handle all patient disputes, by obtaining all pertinent information and noting dispute on account and escalating to supervisor as necessary.
Assists in making outbound calls when necessary.
Performs other activities and responsibilities as assigned.
Must have collection experience in a hospital or agency environment with a proven track record of success in billing, reimbursement and follow up
Experience working with UB 04 and HCFA 1500 claims is preferred
Experience utilizing IDC-10, CPT and HCPC coding systems and materials is preferred
Comprehensive knowledge of insurance plans, member eligibility and medical billing is preferred
Strong background in Medicare and Medicaid claims processing and reimbursement is preferred
Ability to create reimbursement claims and transfer to third-party payers
Ability to synthesize complex or diverse information; collect and research data; use intuition and experience to complement data; design work flows and procedures.
Competent in required job skills and knowledge; uses resources effectively.
Demonstrate required skills; adapt to new technologies; troubleshoot technological problems; use technology to increase productivity; keep technical skills up to date.
Should be able to identify and resolve problems in a timely manner; gather and analyze information skillfully; develop alternative solutions; work well in group problem solving situations; use reason even when dealing with emotional topics.
Manage difficult or emotional customer situations; respond promptly to customer needs; solicit customer feedback to improve service; respond to requests for service and assistance; meet commitments.
Express ideas and thoughts verbally; express ideas and thoughts in written form; exhibit good listening and comprehension; keep others adequately informed; select and use appropriate communication methods.
Speak clearly and persuasively in positive or negative situations; listen and get clarification; respond well to questions.
Education and/or Experience
Must have experience working with medical billing and insurance follow-up. High school diploma is required.