Insurance Billing Specialist II

TEKsystems•Linn Township, IA

2d•Remote

About The Position

The Insurance Billing and Follow Up Specialist II will be responsible for performing all billing and follow-up functions, including the investigation of payment delays, resulting from no response, denied, rejected and/or pending claims with the objective of appropriately maximizing reimbursements and ensuring that claims are paid in a timely manner. This position requires strong decision-making ability around complex claims processing workflows and regulations that requires utilization of data coming from multiple resources. To evaluate billing and follow-up issues appropriately, Reps will need to have an understanding of the entire Revenue Cycle and be able to interact with Government and Commercial insurances.

Requirements

High School graduate or equivalent
Physician Billing and Denial/Follow Up experience - 2+ years
EOB experience, claims correction, disputes
Medicare, Medicaid, and Commercial insurance experience - 2+ years
Payer portal claim corrections and reconsiderations knowledge
Epic experience
Must have Iowa payer experience

Nice To Haves

WPS, NGS, Availity, UHC and Blue Cross payer portal experience
Iowa and Illinois Medicaid payer experience

Responsibilities

Work with centralized cash posting team to resolve missing or unposted remits
Ensure all claims are accurately transmitted daily and all appropriate documentation is sent when required
Verify eligibility and claims status on unpaid claims
Provide timely feedback to management of identified claims issues, repetitive errors, and payer trends to expedite claims adjudication
Work accounts in assigned queues in accordance with departmental guidelines
Work directly with third party payers and internal/external customers toward effective claims resolution.