About The Position

A Billing Follow-Up Specialist is responsible for accurate and timely follow-up for assigned denied or unpaid accounts. This role ensures prompt, accurate reimbursement for services rendered by appealing denials, correcting claims, and working diligently with payers to resolve outstanding balances.

Requirements

  • 1-2 years of experience in healthcare collections, claims follow up, or denial management.
  • High school diploma or GED
  • Ability to work independently with minimal supervision.
  • Detail-oriented with strong problem-solving and communication skills.
  • Proficiency with computer functions, including ability to use automated systems for third party billing and insurance follow up.
  • Professional, business-like appearance and demeanor
  • Recognizes and reports problems, errors and discrepancies to management
  • Shares information with co-workers
  • Ability to contribute to team efforts
  • Ability to assist with training of new employees as needed

Nice To Haves

  • EPIC or Revenue Cycle Certification preferred.

Responsibilities

  • Conduct follow-up on unpaid or denied claims to ensure timely and accurate reimbursement.
  • Analyze denial reasons and take appropriate action to appeal or resubmit claims.
  • Contact payers and utilize online portals to resolve outstanding account balances.
  • Collaborate with billing, coding and clinical staff to gather necessary documentation for appeals or corrections.
  • Track and document follow-up activities in Epic in compliance with department policies.
  • Quickly identify and solve problems, escalating recurring denial trends or payer issues to team leaders when necessary.
  • Responsible to validate the payments and adjustments made on accounts are correct
  • Maintains daily work queues according to work queue prioritization guidelines.
  • Maintain quality and productivity standards and participate in team meetings to discuss recurring issues.
  • Knowledge of payer guidelines, including utilization of payer websites and other tools.
  • Performs other duties as assigned. These may include but are not limited to: Maintaining a current knowledge base of department processes, protocols and procedures, pursuing self-directed learning and continuing education opportunities, and participating in committees, task forces, and work groups as determined by management.
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