Claims Follow-up Specialist

MOBILE MEDICAL RESPONSE INC•Saginaw Charter Township, MI

1d•Onsite

About The Position

The Claims Follow-up Specialist follows-up on Medicare/Medicaid, Blue Cross Blue Shield, Patient Pay and Commercial Payers to effectively and professionally resolve customer and insurance companies’ questions and inquiries. This role involves maintaining HIPAA compliance and performing various follow-up tasks for different insurance types, including processing rejections, denials, appeals, and refunds. The specialist will also handle incoming customer service calls, process payments, obtain correct billing information, and update patient demographics.

Requirements

Proficiency with billing the following insurances, Medicare, Medicaid, BCBS, Commercial
Ability to communicate effectively both verbally and in writing, in a professional manner with customers and patients
Must proficiently use insurance websites i.e., C-Snap, Champs, Web Denis, etc., 2 months after date of hire
Reading skills to comprehend correspondence and materials specific to the healthcare industry
Must demonstrate ability to maintain security and confidentiality with utmost discretion
Ability to communicate effectively both verbally and in writing, in the English language
Ability to organize tasks and insure timely completion of all projects
Advanced computer skills including the ability to utilize a computer PC with Windows operating system
Ability to operate office equipment, including but not limited to, copier, fax machine, scanner, monitor, multi-line telephone, printer, typewriter and calculator
Proficiency with Microsoft Word and Excel
Regular attendance and timeliness
Skilled in typing, data entry, scanning, electronic filing and document retrieval
High School Diploma
Must be at least 18 years old

Responsibilities

Know and support the Mission Statement, Policy/Procedures and standards of MMR.
Maintain HIPAA compliance.
Complete Medicare over 50 mile requests, process follow up rejections/denials and appeals for Medicare and Medicaid claims.
Process Medicare and Medicaid refunds.
Follow-up on lacking Medicare Signatures via mail/phone calls.
Answer incoming customer service phone calls and provide assistance to patients, payers and others as needed.
Process credit card payments.
Facilitate payment for services rendered by soliciting payment in full from incoming calls and, when appropriate, establish payment arrangements or seek completion of a charity questionnaire.
Contact patients and/or insurance company to obtain the correct billing information.
Resubmit accounts when new or corrected information is obtained from the caller or payer.
Enter patient demographics as required from information gathered from correspondence or telephone contacts.
Complete BCBS/Patient Care Report (PCR) information requests.
Process BCBS rejections/denials.
Process BCBS refunds.
Process mail returns.
Follow-up with commercial payers including auto.
Assist Patient Pay follow up as necessary.
Process commercial insurance refunds.
Process return mail and change of address (NCOA).
Place accounts in collections after determining that there is not active insurance to bill.
Process patient refunds.
Perform other duties as assigned.