Remote Medical Insurance Follow-up Representative

Remote Medical Insurance Follow-Up Representative

Job Summary:

For more than 20 years RSi has been a leading revenue cycle management service provider for the hospital and large physician practice market. The Remote Medical Insurance Follow Up Representative researches and works on denied insurance claims with insurance companies and follows-up accordingly to resolve claims for payment. Our representatives are high performers who are resilient and consistently go above and beyond to deliver outstanding results for our customers. Our culture is driven by sharp, committed, and enthusiastic employees. Are you the next member of our Team?

Job Responsibilities: ? Follow-Up with Insurance Carriers to determine reason for claims denial and work to resolve claim for payment. ? Resolve insurance denials and file appeals with government and commercial carriers. ? Report unusual accounts, account problems and workflow issues promptly to manager. ? Process claims, payments, adjustments, refunds, denials and unpaid insurance balances ? Stay up to date on contract, regulation, procedure and other changes affecting the department. ? Analyze the unpaid claims and denials and identify/investigate the reasons for nonpayment and which action is needed to resolve timely. ? Serve as a liaison with insurance companies, third party payors, and administrative personnel ? Provide accurate account maintenance and documentation ? Use and demonstrate understanding of applicable computer systems, including system reports and security procedures. ? Work effectively with other staff members to accomplish work and departmental goals. ? Perform various collection actions including possibly contacting patients by phone, updating insurance information, and follow through on insurance processes. ? Adhere to applicable policies, hospital/physician billing/departmental practices and 3rd party requirements. ? Operate within the guidelines of the Health Insurance Portability and Accountability Act (HIPAA) and any other applicable Federal or state laws and company policies. ? Demonstrate positive and professional communication skills. ? Perform other work duties as assigned.

Required Skills/ Abilities:
? Results-Oriented
? Strong written and verbal communication skills
? Ability to handle and maintain confidential information
? Ability to manage multiple projects effectively
? Ability to collaborate effectively with team to ensure project deadlines are met
? Thorough understanding of CPT, DRG, HCPC, Procedure and Revenue codes, modifiers and their effect on reimbursement

Education and Experience:
? High School Diploma required, AA+ preferred.
? 3-5 years of insurance follow-up experience in a hospital or physician?s office setting is required.
? Experience with filing UB-04 and HCFA 1500 claim form required.
? Experience in utilizing add on software such as: SSI, IDX/Centricity (preferred), Epic, FastTrack, Meditech, Cerner, and various other systems.

Physical Requirements: ? Prolonged periods sitting at a desk and working on a computer. ? Must be able to lift up to 15 pounds at times.

Compensation: $16.00 - $20.00 per hour

Shift: Mon- Fri 8am-5pm

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