Insurance Follow Up Rep

Requisition ID
2021-151567
Employment Type
Full Time
Department
Cardiology Clinic
Hours / Pay Period
80
Shift
Day
Standard Hours
Monday - Friday (8:00 AM - 5:00 PM)
Facility / Process Level : Name
CHI Memorial
Location
TN-CHATTANOOGA

Overview

CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. & from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.

Responsibilities

Job Summary:

 

Responsible for follow up of insurance to include: claims submitted, appeal processes and inquiries; monthly accounts receivable reports to ensure timely and maximum reimbursement from assigned insurance carriers.

 

Essential Responsibilities:

  • Field patient and insurance calls regarding patient account receivables.
  • Audit patient accounts for accuracy regarding charges, payments, demographics, insurance information and filing to ensure contractual agreements are being met.
  • Request adjustments, write-off, payment, refunds/recoups, and transfers when appropriate.
  • Work insurance aging reports, review claims status, patient eligibility, accuracy of account information and modify as needed to ensure proper and timely payment while maintaining A/R aging per company guidelines to maximize remibursement.
  • Submit patient claims, paper and electronic, after corrections have been made or when rebilling is needed.  Create appeal letters to submit to insurance carrier for timely payments.
  • Review and reply (as needed) to all insurance correspondence, including assigned carrier newsletters and guidelines as well as maintain a working knowledge of assigned carrier newsletters and guidelines as well as maintain a working knowledge of assigned carrier website.
  • Maintain current knowledge of insurance guidelines through newsletters and websites.
  • Assist with demographics/charge entry and capture of all hospital charges.
  • Work in all areas of the department during peak times, vacations, illnesses, etc.

Qualifications

Education:

  • High school diploma or equivalent; some college preferred.

Qualifications:

  • Two or more years in health insurance processing; medical office preferred.

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