Billing Follow Up Representative Lead
About The Position
This is a full-time, fully remote position for a Billing Follow Up Representative Lead. The role involves daily claims submissions, communication with internal and external parties to resolve charging issues, and reporting trends to improve the claims submission process. Responsibilities also include potential collection of insurance receivables, reviewing assigned accounts, responding to correspondence regarding insurance claims, applying contractual allowances, assisting the team with complex issues, training, and providing feedback. The lead will monitor and audit productivity and quality, analyze daily statistics, and provide feedback to other billing representatives. They will also attend meetings, share training knowledge, stay updated on payer changes, and assist management with implementation recommendations. Additionally, the role requires prioritizing rejections and denials to avoid timely filing limitations, assessing and resolving advanced projects, and researching/distributing new information from insurance payers regarding contracts, guidelines, reimbursement rules, and computer systems.
Requirements
- High School Diploma or General Education Degree (GED)
- Typically requires 5 years of related experience in medical/billing reimbursement environment, or equivalent combination of education and experience.
- Proficient in all follow up rep functions.
- Demonstrated ability to work and solve billing / follow up issues in a healthcare environment.
- Broad and comprehensive knowledge and understanding of department-specific procedures.
- Strong analytic, organization, communication (written and verbal), and interpersonal skills.
- Ability to successfully lead, coach, and train a team, and problem solve complex accounts.
- Knowledge of medical terminology, coding terminology (CPT,ICD- 10,HCPC), and insurance/reimbursement practice.
- Able to use Zoom, Microsoft office, or other communication software for meetings.
Responsibilities
- Responsible for daily claims submissions to the appropriate payer source.
- Communicates with internal and external parties to resolve charging issues affecting the claims.
- Reports trends with other departments that may improve the claims submission process.
- May be responsible for collection of an assigned section of the insurance receivables, following all procedures and guidelines established.
- Reviews assigned accounts and takes appropriate course of action: internal or external problems that may cause a delay in reimbursement.
- Responds to telephone or written correspondence from internal and external parties regarding insurance claims.
- Applies contractual allowances where necessary.
- Assists team with more complex issues to resolve problems, provides necessary training, and provides ongoing feedback on performance.
- Monitors and audits productivity, quality and analyzes daily statistics looking for any trends which are reported to management.
- May provide feedback to Billing Rep I and II.
- Attends and participates in meetings as required, attend outside seminars and be used as “train the trainer”.
- Share training knowledge with others as appropriate.
- Keeps abreast with insurance payor updates/changes and assists management with recommendations for implementation.
- Prioritize rejections to avoid timely filing insurance appeal limitations, may include denials.
- Accountable to assess and resolve advanced projects as assigned.
- Research/Distribute new upgrades/information from the Insurance Payers re: Contracts, guidelines, reimbursement rules and regulations and for computer systems.
Benefits
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
