AR Follow Up Reps

TEKsystems•Chesapeake, VA

3d•Onsite

About The Position

Hospital Billing and Follow-up ensures the submission of timely and clean Inpatient/Outpatient claims to the various government/non-government payers and takes the appropriate action to resolve claim issues in order to accelerate cash collections. The role involves working out of EPIC work queues or an Aged Trial Balance report to address aged accounts, prioritizing high-dollar accounts and organizing reports by claim age. Responsibilities include reviewing accounts for payments and denials, working denials, requesting and loading medical records, contacting insurance companies to resolve denied claims, updating coordination of benefits with patients, and analyzing trends to identify recurring denial reasons. The position requires meeting daily metrics of working 50+ accounts, utilizing systems like EPIC, payer portals, the scanning system (on base), and Excel for feedback on aged trial balances. Work is typically divided by denial type, such as registration or authorization denials.

Requirements

High School Diploma minimum requirement.
Strong Excel experience.
Follow Up experience.
Appeals experience.
Denied claims experience.
Insurance experience.
Facility Billing experience is a plus.
Hospital Billing experience is a plus.
EPIC experience is a plus.
Ability to work independently and make decisions relative to individual work activities.
Follows HIPAA guidelines in order to maintain strict confidentiality of all patient financial and hospital information at all times.

Nice To Haves

Hospital billing experience is a plus.
EPIC is a plus.

Responsibilities

Work out of EPIC work queues or an 'ATB report' (Aged Trial Balance report) to hit aged accounts more quickly.
Work high dollar accounts first, then work down from there, organizing their report by age of claims from oldest to newest.
Review accounts to determine what has been paid and what has been denied, then begin working from there.
Work denials by contacting insurance companies to understand why claims are denied.
Request medical records from medical records department if needed and load them onto the provider portal.
Contact patients to update coordination of benefits.
Perform any necessary actions to get claims paid.
Analyze trends to identify constant reasons for denials and collaborate with the manager to fix these issues moving forward.
Submit Inpatient/Outpatient electronic and paper claims (UB-04 and 1500) to the appropriate government and non-government payers.
Resolve Billing errors and/or warnings identified in the Patient Accounting and Billing System.
Stay informed about payer-specific and government requirements and regulations.
Ensure claim information is complete and accurate to accelerate cash collections.
Analyze information within the Patient Accounting and Billing system to make decisions on how to proceed with billing an account.
Process rejections by correcting any billing error and resubmitting claims.
Place unbillable claims on hold and communicate necessary information to various Hospital departments for accurate billing.
Process late charge claims if charges are not entered in a timely fashion.
Submit corrected claims if original claim information has changed.
Perform billing for complex scenarios such as interim, self-audit, combined, and split billing.
Review all imported claims and either bill or hold them for further review to limit the number of unreleased claims.
Meet Billing productivity and quality requirements as developed by Leadership.
Record or generate revenue by gathering and processing information that impacts the patient revenue process.
Review patient financial records and/or claims prior to submission to ensure payer-specific requirements are met.
Follow up on unprocessed or unpaid claims until a claims resolution is achieved.
Generate letters to insurance or patients as needed to resolve unpaid claim issues.
Work on and maintain spreadsheets by sorting/adding pertinent data.
Identify comments in the billing systems by using initials and approved abbreviations.
Maintain clear, concise, and to-the-point documentation, including enough information for a clear understanding of work performed and actions needed.
Create appropriate documentation, correspondence, emails, etc., and ensure they are scanned to the proper account.
Read, understand, and explain benefits from all payers to coworkers, physicians, and patients.
Make phone calls, use the internet, and send mail to payers for follow-up on unprocessed claims, incorrectly processed claims, or claims in question.
Develop relationships with customers/patients/coworkers to gather and process information or resolve issues for accurate reimbursement and optimize customer satisfaction.
Post accurate adjustments as appropriate per billing policies and procedures, payer explanation of benefits, and management directive.
Maintain work procedures pertinent to the job assignment.
Resolve questions regarding correct charging or other concerns regarding services provided.
Complete cross-training as deemed necessary by management.
Report potential or identified problems with systems, payers, and processes to the manager in a timely manner.
Complete special project assignments in a timely fashion.
Follow HIPAA guidelines to maintain strict confidentiality of all patient financial and hospital information.
Perform other duties as assigned.