Specialist at Reid Health in Richmond, IN

📌 Richmond 🏷️ Other 🕑 2021-07-24
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PFS HB Billing-Ins Follow Up Specialist

Overview: Initiates billing and follow up/collection actions utilizing appropriate processes, web status updates, telephone calls, faxes, as necessary to resolve outstanding insurance balances on patient receivables. Requests and completes rebills when and where necessary. Responsible for ensuring assigned insurance balance does not age past filing deadlines based on payors' specific requirements. Responsible for requesting PFS management interaction when a claim is approaching timely filing limit, have received denial status and/or evaluating other pertinent information and they are unsure of how to proceed to get the claim paid. Additionally, management should be notified if payor is unresponsive. Billing & Follow Up Specialist will respond to requests for information from patients or payors about claims or coverage. Demonstrates Reid Hospital's C.A.R.E. principles and Key Service Behaviors in interactions with those they are privileged to serve.

Responsibilities

Will follow up on accounts with insurance payers in a timely manner to avoid any timely filing losses. Utilizes telephone contacts, faxes, Internet, or other means as appropriate. Will resolve claim edits and submit claims that are ready for billing. Verifies insurance coverage by investigation or interview. Responsible for ensuring no assigned insurance balance goes beyond any filing deadline. Reviews insurance credit balances and refunds payor when appropriate. Responsible for engaging PFS management when a claim is approaching its timely filing limit and they are unsure of how to get the claim paid, or unable to get the insurance/other responsible party to respond. Works in a high stress environment responding to and placing numerous phone calls over short periods of time. Must handle negative situations with a positive, pleasant manner in order to resolve them with a positive outcome. Performs additional duties as assigned by PFS Revenue Cycle Manager

Qualifications

Ability to communicate effectively with both internal and external customers in order to resolve insurance balances in a timely and efficient manner. Must be able to make independent decisions and solve problems based upon department specific processes. Knowledgeable of both government and commercial expected reimbursement and explanation of benefits. Must be familiar with government medical programs such as Medicare, Medicaid, Champus, etc., and the associated payment methodology. Must have understanding of all hospital and physician charges billed by Reid. Must be familiar with UB-04, 1500, 837I and 837P formats. Must be familiar with ICD 9 and CPT codes. Must be competent in Microsoft Office applications. Must have understanding of cash posting process and application to patient's bills. Knowledge of Epic Resolute Hospital and Professional billing system is preferred. Must be able to work accurately with numbers. Must have good clerical skills such as typing, data entry, and calculator operation. Successful completion of Reid Hospital competency-based skills appropriate for the job. Must be customer oriented and able to work under stressful conditions.

Schedule

Details: Day Shift. Monday-Friday, flexible schedule between 6a
- 6p. No weekends/holidays (except for rare projects).

View Application

You will be redirected to Reid Health's preferred application process.

You will be redirected to Reid Health's preferred application process.

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