AR Follow-Up Specialist, Hospital Billing

UMass Memorial Health•Worcester, MA

1d•Onsite

About The Position

This position is responsible for resolving outstanding no-response and post-appealed accounts receivables in the circumstance that balances have not been adjudicated and performing all related tasks. At UMass Memorial Health, everyone is a caregiver, and this role plays an important part in the relentless pursuit of healing for patients, the community, and each other. The health system is comprised of more than 20,000 employees working together to provide exceptional patient care, academic excellence, and leading-edge research, making it the premier health system of Central Massachusetts.

Requirements

High School diploma
Previous Revenue Cycle knowledge including experience in one of the following areas PFS, Customer Service, Cash Posting, Financial Assistance, Patient Access, HIM/Coding or 3rd party Reimbursement.
Ability to perform assigned tasks efficiently and in timely manner.
Ability to work collaboratively and effectively with people.
Exceptional communication and interpersonal skills.

Nice To Haves

One or more years of experience in health care billing functions.
Experience in accounts receivable follow-up process.

Responsibilities

Performs follow up on accounts that have not been initially adjudicated by the payer utilizing assigned work queues and prioritization standards.
Follows up on open receivables after appeal has been submitted by Revenue Cycle departments.
Utilizes payor technology and resources to support account resolution activities.
Follows established protocols to ensure all documents are scanned in appropriately.
Maintains current knowledge of payer response time.
Responds to incoming inquiries from attorneys, payers, employers, etc., following all hospital and regulatory guidelines.
Analyzes and researches accounts to determine root cause of open receivables to determine and execute the best approach for timely and accurate resolution.
Releases patient information following Federal, State and Hospital guidelines.
Adjusts account balances using correct transaction, code adhering to guidelines.
Corresponds with third party payers, hospital departments, and patients to obtain information required for account receivable resolution.
Works with team leader and/or Supervisor on account resolution strategies that optimize reimbursement.
Escalates issues timely.
Uses established guidelines and provides support documentation needed for payer audit requests.
Uses reference material to troubleshoot payer issues and increase understanding of account resolution techniques.
References payer websites as needed to acquire knowledge and understanding of appropriate follow up actions.
Meets established productivity standards.
Facilitates and promotes the sharing of knowledge and content throughout departments.
Follows all established Hospital Billing Revenue Cycle Management departmental and compliance policies and procedures.
Adheres to change control processes.
Participates in cross training to optimize department resources.
Maintains and fosters an organized, clean and safe work environment.
Contributes to the development and application of process improvements.
Maintains a collaborative, team relationship with peers and colleagues to effectively contribute to the group’s achievement of goals and to help foster a positive work environment.
Practices cost containment and fiscal responsibility through the efficient use of supplies, equipment, time, etc.