Insurance Follow Up Rep
US-WA-TACOMA
commonspirit_careers
Req #: 431812
Type: Day
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Overview: Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved over the years through strategic partnerships and integrations to expand our reach and services across the Puget Sound area. Today, as Virginia Mason Franciscan Health, we remain deeply committed to healing the whole person - body, mind, and spirit - in the communities we serve. This commitment is strengthened by the diverse expertise and shared values brought together through our growth. Our dedicated providers offer a full spectrum of health care services, from routine wellness to complex disease management, all grounded in rigorous research and education. Our comprehensive network of 10 hospitals and nearly 300 care sites strategically located across the greater Puget Sound region reflects our ongoing commitment to accessibility and comprehensive care. We are proud of our pioneering medical advances and numerous awards and accreditations that reflect our dedication to excellence. When you join Virginia Mason Franciscan Health, you become part of a team that delivers top-quality, professional healthcare in modern, well-equipped facilities, and contributes to a legacy of service built on collaboration and shared purpose. Responsibilities: Franciscan Medical Group, as part of Virginia Mason Franciscan Health is currently seeking a full time Insurance Service Follow Up Rep for the Franciscan Medical Group Regional Billing Office in Tacoma, WA. Flexible start times, 5 days a week and no weekends required! Job Summary: This job is responsible for corresponding with both commercial and government health insurance payers to address and resolve outstanding insurance balances and denials for the Franciscan Medical Group (FMG) in accordance with established standards, guidelines and requirements. An incumbent conducts follow-up process activities through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently. Work also includes reviewing insurance remittance advices, researching denial reasons and resolving issues through well-written appeals. Work requires proactive troubleshooting, significant attention to detail and the application of analytical/critical thinking skills to analyze denials and reimbursement methodologies and bring timely resolution to issues that have a potential impact on revenues. In addition, the incumbent must be able to communicate effectively with payer representatives and maintain professional communication with team members in order to support denials resolution. Essential Duties: * 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 received for all FMG providers. * Identifies potential trends in denials/reimbursement by payer or by type, denial reason, or coding issue and reports to supervisory staff for appropriate escalation. * Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records. * Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function. * Establishes and maintains professional and effective relationships with peers and other stakeholder. Qualifications: Education/Experience: * Two years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities. * Graduation from a post-high school program in medical billing or other business-related field is preferred.
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