Denials and Follow-up Rep (Government) - Revenue Cycle - Full Time

Ochsner Health-posted 4 months ago
Full-time
Remote • New Orleans, LA
Ambulatory Health Care Services
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This job is primarily responsible for resolving all outstanding insurance account receivables. Responsibilities include, but are not limited to, performing collection and billing activities related to account resolution, and communicating with payors (Government and Commercial), clients, reimbursement vendors, and other external resources such as patients.

  • Performs account research with internal and/or external resources via phone and payor websites to determine status of the account with the expected result of obtaining payment of the account.
  • Verifies and/or updates insurance and demographic information for accuracy to resolve barriers in receiving payment of the account.
  • Follows-up with payors and checks claim status as needed throughout the payment process.
  • Appeal denials when needed throughout the payment process and determines when appeals should be sent for further research and/or review.
  • Maintains knowledge of differing payor guidelines to ensure accurate reimbursement by various resources, such as department meetings and updates on payor websites.
  • Identifies trends that may cause or are causing various types of issues on assigned accounts and reports to leader with recommendations for system improvements/edits.
  • Other related duties as required.
  • High School diploma or equivalent.
  • 1 year related experience in related hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service related job.
  • Associates Degree or Bachelor Degree.
  • Prior experience working with EPIC system.
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