Under the direction of the Physician Revenue Realization management team, the Insurance Follow Up Representative is responsible for:
Investigating claims status with insurance carriers to determine root cause of nonpayment.
The Insurance Follow Up Representative is responsible for correcting and resubmitting denied claims, writing appeals and contacting insurance companies to ensure claim resolution for maximum reimbursement.
The Insurance Follow Up Representative will be expected to work with and effectively communicate with supporting departments within Revenue Cycle as part of the claim investigation and resolution process (departments include, but not limited to, Cash Management, EDI, HIM-Coding, Patient Financial Services).
The Insurance Follow Up Representative may also be expected to review and work edits related to Pre-AR and pre-claim submission.
The Insurance Follow Up Representative is expected to have an understanding of CPT and Diagnosis coding, as well as understand insurance requirements and policies.
The Insurance Follow Up Representative reports directly to the Physician Revenue Realization Follow Up Supervisor.
High School Diploma or GED
Relevant Experience in insurance company follow up regarding claims denials
Excellent computer skills and phone communication experience