Accounts Receivable Specialist - Insurance Follow-Up

ThedaCare • Neenah, WI

252d

About The Position

The Accounts Receivable Specialist submits billing to the appropriate party and follows-up for adjudication and payment of individual claims. Communicates with insurance and other payers, patients, guarantors, family members, and/or other medical staff for status of individual claims to manage accounts receivable.

Requirements

• High School diploma or GED preferred
• Must be 18 years of age

Responsibilities

• Performs comparative analysis for accuracy of bill before submission to appropriate parties (i.e., charges, subscriber data, diagnosis/procedure codes, and late charges).
• Processes claims in a timely manner according to contracts, regulations, department standards, and form requirements.
• Generates phone calls to all parties to check status of unprocessed, unpaid, or rejected claims ensuring accurate and timely reimbursement.
• Processes variety of correspondence from all parties taking appropriate steps to expedite timely resolution of claims payment.
• Verifies insurance/payer and patient demographic information for accuracy of data collected at time of registration when appropriate. Inputs verification data to complete in-house claims generation of billing forms.
• Re-bills accounts when new information is received requiring account updates with appropriate demographic and third party information to ensure payment. Updates patient record to indicate changes made.
• Reviews internal and external reports for claims status.

Benefits

• Lifestyle Engagement e.g. health coaches, relaxation rooms, health focused apps (Wonder, Ripple), mental health support
• Access & Affordability e.g. minimal or zero copays, team member cost sharing premiums, daycare

What This Job Offers

• Job Type: Full-time
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED