Insurance Follow Up Rep
Posted on May 9, 2019 by CMP.jobs
Job Type: Full Time
Hours: 8am to 4:30pm
Weekends Required: None
Location, Franciscan Administrative Center, Tacoma, WA
CHI Franciscan Health has exciting and rewarding careers with competitive salaries and benefits. We are a family of hospitals, health care services, and medical providers delivering compassionate care to people throughout the South Puget Sound. We are part of Catholic Health Initiatives, one of the largest not-for-profit health care systems in the country.
Our mission is to deliver high quality care that meets our patients' medical needs while providing emotional and spiritual support to patients and their families. We believe this three-part approach - physical, emotional, and spiritual - is essential to healing the whole person. Come join our team!
This job is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and denials for the Franciscan Medical Group (FMG) in accordance with established standards, guidelines and requirements. An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently. Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals.
Work requires proactive troubleshooting, significant attention to detail and the application of analytical/critical thinking skills to analyze denials and reimbursement methodologies and bring timely resolution to issues that have a potential impact on revenues.
In addition, the incumbent must be able to communicate effectively with payer representatives and maintain professional communication with team members in order to support denials resolution.
- Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is received for all FMG providers.
- Identifies potential trends in denials/reimbursement by payer or by type, denial reason, or coding issue and reports to supervisory staff for appropriate escalation.
- Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records.
- Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function.
- Establishes and maintains professional and effective relationships with peers and other stakeholders.
- Adheres to and exhibits our Core Values of Reverence, Integrity, Compassion and Excellence.
- Two years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities. Graduation from a post-high school program in medical billing or other business-related field is preferred.
- Not applicable.
- Requisition ID: 2019-R
- Schedule: Full-time
- Shift: Day Job
- Market: Employer