Billing Office Insurance Follow-Up Specialist

The Billing Office Insurance Follow-up Specialist is responsible for working the unpaid insurance claims work queues and following up on any unpaid. To keep within insurance filing parameters, this person also follows-up on unpaid insurance claims when they have aged; and investigates all insurance claims in the 120 days column of the Accounts Receivable Report, clearing out the Accounts Receivable as quickly as possible. This specialist will also show flexibility as they will be responsible for assisting the charge posting team as assigned by manager and within parameters outlined by manager.

Essential Job Functions

• Check Insurance Unpaid Claims work queues daily, reviewing and following-up on all claims that remain unpaid in the 60 days and older column.
• Cross-check Unpaid Claims work queues using Accounts Receivable Report and follow-up on all claims that remain in the 60-days or higher unpaid column.
• Check the Waystar claims clearinghouse reports, monitoring any claims not received and checks for other errors in electronic billing process. Correct errors, as necessary.
• Maintain the tracking system within EPIC for all claims appealed, rebilled, or that require additional monitoring for timely filing.
• Contact insurance companies to check on progress of processing rebilled and appeal requests as well as the status of claims received and why they have not been paid. Use insurance websites, when possible, to obtain necessary information.
• Utilize correct insurance forms to appeal decisions and write necessary cover letters when needed during the appeals process.
• Communicate with insurance companies regarding billing issues.
• Educate patients regarding their accounts and answer patient questions about unpaid claims, or other processed claims coding questions.
• Process Insurance refund requests.
• Checks doctors’ ICD10 coding and CPT4 codes against the documentation for accuracy.
• Discusses any questionable choices with the physician so ensure accurate claims filing.
• Demonstrates effective and efficient work habits by completing daily tasks related to the billing function.
• Understand and adhere to all HIPAA regulations to maintain our patients’ privacy.
• Requires regular, predictable attendance.
• Flexibility is essential for success with CFG and on occasion, our employees may be asked to complete projects and tasks that could be outside of their normal scope of duties.

Required Competencies

• Effective Communication – both verbal and written
• Documentation and Information Recording – Possess excellent attention to detail as well as data entry skills.
• Customer Service – Ability to respond to questions appropriately and listen attentively.
• Professionalism – Build solid working relationships and support co-workers to foster a friendly work environment.
• Time Management – Must be able to work under pressure and complete projects according to established timeframes.

· Demonstrated comfort with Windows-based computer systems.

· 3+ years of experience in a Medical Billing Office or Revenue Cycle Office Setting

· 2 years of experience directly working with payers and/or claims follow-up

· Knowledge of CPT & ICD10

Preferred Competencies and Experience

· 5 years of experience with payers and claims follow-up

· Ability to speak, read, and write Spanish—other languages are appreciated too!

· Experience with portals and software such as Availity and other individual payer sites

Performance Measures

· Maintain aging accounts over 120 days between 10-20%.

Working Conditions and Physical Requirements

• Ability to walk, stand, stoop, bend, or sit for extended periods of time.
• Physical demands: percentage of time spent in each activity (estimate)
• Walking 10% - assisting patients, delivering information personally to other departments, collaborating with other department employees.
• Sitting 90% - answering the telephone, scheduling appointments and procedures in the call center, working at the front desk, working on the computer.
• Number of pounds that must be lifted, carried, pushed or pulled: up to 20lbs.
• Climbing on step ladders to reach top shelves, stooping, kneeling, crouching, reaching, fingering (like keyboarding, controls on a scanner, fax, etc.)
• Ability to speak clearly to be understood by our patients and employees.
• Ability to hear within normal range.
• Acuity near and far. Ability to see within normal parameters, and to distinguish colors.
• Ability to work for extensive periods at computer keyboarding.
• Works in a well-lit heated/air-conditioned environment. Temperatures between 68 and 74 degrees.
• Work may involve exposure to communicable diseases, medicinal preparations and other conditions common to a clinic environment.

Equipment used

Computer, printer, multi-line telephone, headset, fax machine, scanner, postage machine

Benefits

The Centers for Gastroenterology is proud to offer medical, dental, vision, life insurance, identity theft protection, a monthly HSA contribution, a 401(k) option with employer matching, 7 paid holidays, a personal holiday, a generous PTO package, a quarterly bonus program, an Employee Assistance program, voluntary accident and critical illness benefits, professional development opportunities, and of course, an awesome work environment!

Equal Employment Opportunity

Centers for Gastroenterology is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, military, or veteran status.

Job Type: Full-time

Pay: $19.10 - $23.35 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• Hybrid work
• Medical office
• Office
• Private practice

Experience:

• medical billing or revenue cycle: 3 years (Required)
• claims follow up: 2 years (Preferred)

Ability to Commute:

• Fort Collins, CO 80525 (Required)

Work Location: Hybrid remote in Fort Collins, CO 80525