Professional Insurance Follow-Up Specialist I

Oklahoma Heart Hospital•Oklahoma City, OK

About The Position

Join Our Team at Oklahoma Heart Hospital (OHH) ONE TEAM. ALL HEART. At OHH, we believe that patient care is truly at the heart of everything we do. Our dedicated team members are involved in every step of our patients’ journeys, bringing hope, compassion, and healing to both patients and their families. Together with our physicians and caregivers, we’re shaping the future of heart care in Oklahoma by serving the state and leading the nation. Why You'll Love Working Here: Comprehensive Benefits: Medical, Dental, and Vision coverage 401(k) plan with employer match Long-term and short-term disability Employee Assistance Programs (EAP) Paid Time Off (PTO) Extended Medical Benefits (EMB) Opportunities for continuing education and professional growth Please note that benefits may vary by position, and some roles (like PRN, Flex, Float, etc.) may have exclusions. For eligible positions, benefits start on your first day! We can’t wait for you to join our heart-centered team!

Requirements

Education: High School Diploma or Equivalent
Experience One (1) year job related experience in Health Care required.
Knowledge of third-party reimbursement, including Medicare, Medicaid and commercial insurance required.
Experience with the Medicare online system.
Excellent Customer Service background.
Good investigative skills and telephone techniques.
Must have good oral and written communication skills.
Proven organization skills needed.
Must possess a foundational knowledge of information systems.
Knowledge of third-party reimbursement, including Medicare, Medicaid and commercial insurance required.
Experience with the Medicare online system and Payer portals.
Excellent Customer Service background

Responsibilities

The Professional Insurance Follow-up Specialist will be responsible for collections and follow-up with insurance company to obtain prompt /accurate payment on accounts.
Functions include numerous phone calls with insurance companies and patients, extensive investigating for timely insurance payments, always cognizant of timely filing deadlines.
Follow-up on Medicare, Medicaid, and Commercial encounters via the web portals and online systems.
Supervises no employees.
Makes independent decisions as to the management of accounts.
Requires extensive contact with the public and employees.
Handles confidential information.
Performs all work in accordance with the mission, vision and values of Oklahoma Heart Hospital.
Using assigned work lists, contacts insurance companies to confirm claim receipt, obtain payment and estimated payment date within 90 days of billed date.
Works received correspondence weekly in order to obtain resolution of pending accounts.
Work with adjacent teams to ensure all EDI information is accurate and updated.
Update help desk tickets with statuses and outcomes.
Answer inquiries within 48 hours to maximize reimbursement timely.
Works denials from assigned Remittance Advices weekly & according to policy and procedure.
Document clearly and completely all actions taken on encounters promptly.