Role and Responsibilities
The AR Follow Up Representative is responsible for ensuring that healthcare providers receive timely and accurate reimbursements from insurance companies for the services provided to patients by reviewing and following-up on all unpaid/no response claims and identify the reasons for not paying per contract and complete all necessary changes to get claims paid. We are looking for someone tenacious, conscientious and a real problem solver.
DUTIES AND RESPONSIBILITIES:
- Requesting EOBs via Mail, FAX, and Downloading EOBs from payer’s portal.
- Appeal denied claims in case of rejection with proper documentation and follow up on the appeal to ensure a timely resolution.
- Checking check deposit/check encashment date confirmation.
- Follow up on unpaid claims within standard billing cycle time frame through IVR, Calls and online payer’s portals.
- Run AR report at specified age in the billing cycle and identify unpaid claims with insurance carriers.
- Verify accounts with incorrect insurance, incorrect referrals or incorrect demographic and update accounts with correct information.
- Meets productivity and accuracy expectations of the position.
- Document details of activity on each account in the claims processing system.
- Maintaining workflow to keep aging accounts at a minimum by following up on unpaid claims daily.
- Follow-up on any assigned special projects designated by the Manager.
- Become familiar with assigned payer(s) billing guidelines, timely filing and follow up limits, contractual allowances, and payer(s) websites.
- Ensure patient privacy according to HIPAA requirements.
NECESSARY ATTRIBUTES:
- Demonstrated ability to work cross-functionally to problem-solve and meet customer expectations.
- Medical billing experience is preferred.
- Good problem solving and decision-making skills.
- Excellent time management, organizational, communication, multitasking and teamwork skills.
- Strong interpersonal skills.
- Basic computer skills.
- Willingness to learn (medical terminology, insurance processes, etc.).
- Ability to work in a fast-paced environment and handle multiple calls/tasks simultaneously while maintaining a pleasant demeanor.
QUALIFICATIONS:
- High school diploma or equivalent.
- 1 Year of relevant healthcare, customer service, or call center experience is preferred; however, we will train the right candidate who has no experience.
- Ability to handle confidential and sensitive information.