Billing Follow-Up Representative

CompuNet Clinical Laboratories • Moraine, OH

3d • Hybrid

About The Position

This position is responsible for performing daily account processing tasks within the Billing Department. This includes billing data entry, third-party billing and follow-up, reviewing denials and resubmitting claims, and handling both incoming and outgoing calls to patients and clients. The role requires maintaining positive relationships with patients, clients, and third-party payers, ensuring an organized workflow, and adhering to department standards and compliance regulations.

Requirements

• High school graduate or equivalent required.
• Previous experience in a medical billing environment preferred.
• Working knowledge of Medicare and other third-party claims processing, ICD-10 and HCPS/CPT coding and medical terminology highly desirable.
• Visual acuity and hand-finger dexterity to work at computer for extended periods.
• Ability to sit at computer work station for extended periods.
• Sound reasoning ability and independent judgment.
• Ability to work within specified deadlines and timetables.
• Excellent communication and people skills.
• Ability to handle stressful situations in a calm manner.
• Familiarity with and adherence to safety, ergonomic, and health policies of the Company.
• Compliance with all PPE requirements when in the laboratory or other biohazard areas.
• Completion of required safety training and health evaluations in a timely manner.
• Ability to anticipate safety hazards, act upon unsafe situations and promote safety awareness.

Nice To Haves

• Previous experience in medical billing environment.
• Working knowledge of Medicare and other third-party claims processing, ICD-10 and HCPS/CPT coding and medical terminology.

Responsibilities

• Perform daily account processing tasks including billing data entry, third party billing and follow up.
• Review denials and resubmit claims.
• Answer incoming and place outgoing calls to patients and clients.
• Maintain organized workflow for efficient processing of accounts and smooth transition of job duties during absences.
• Consult with supervisor when questions regarding account processing arise.
• Exhibit good customer service skills when dealing with internal and external customers.
• Project a positive image of the department and organization.
• Engage in behaviors that foster teamwork.
• Meet or exceed department standards for quantity and quality of work.
• Possess working knowledge of relevant compliance regulations and apply this knowledge to daily job duties.
• Comply with all departmental, company, and regulatory policies and procedures.
• Maintain statistical data as required.
• Perform order entry accurately.
• Research and resolve missing information from client orders.
• Use translation tools to enter codes into billing systems.
• Apply payment detail to client and patient accounts, including contractual disallowances and patient copays/deductibles.
• Review overpayments, initiating refunds or correcting misapplied payments.
• Read and understand various payer’s Explanation of Benefits.
• Review un-adjudicated claim reports and contact insurance carriers to determine the reason for non-response.
• Perform follow-up as appropriate to resolve outstanding accounts.
• Process Medicare denials for medical necessity.
• Monitor payer rejections and denials for trends.
• Review claim development reports for insurance denials, contact insurance carriers to determine denial reasons, and work with carriers to rectify unpaid claims.
• Handle a fast-paced, high call volume environment with above-average multi-tasking skills.
• Focus on positive customer impact.
• Utilize verbal and written communication effectively.
• Research collection accounts as requested by patients or collection agencies.
• Review system error codes and make corrections to accounts.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED