Insurance Follow Up Rep
US-NE-OMAHA
commonspirit_careers
Req #: 449888
Type: Day
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Overview: From primary to specialty care, as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours. Responsibilities: As an Insurance Follow Up Rep, you will resolve unpaid insurance claims and collect outstanding balances from third-party payers. Every day you will review denials, initiate follow-up with insurers, rectify billing errors, submit appeals, and negotiate for maximum reimbursement. To be successful, you will understand billing regulations, possess strong problem-solving skills, and communicate effectively to optimize revenue recovery. * Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is receive. * Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. * Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. * Resubmits claims with necessary information when requested through paper or electronic methods. * Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. * Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. Qualifications: Preferred * High School GED General Studies and Two years of revenue cycle or related work experience , upon hire or * High School Graduate General Studies and Two years of revenue cycle or related work experience , upon hire and * Graduation from a post-high school program in medical billing or other business related field is , upon hire
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