Hospital Insurance Follow Up Representative

Horizon Financial Management is an established, competitive revenue cycle company looking for a full-time Insurance Follow-up Representative. This is a fully remote position, and we are currently accepting applicants in the following states only: IN, IL, GA, WV, KS, AR, FL, VA.

Basic understanding of medical billing and follow-up is required with at least 1-2 years of experience preferred. Experience with transaction posting and Indiana Payers is required. A background in hospital billing with knowledge of Epic is a plus. The ideal candidate is reliable, organized, team-oriented and self-motivated. Applicants must also be able to multi-task, communicate effectively, problem solve and meet production goals.

Our company offers a 10-hour 4 day a week or an 8-hour 5 day a week schedule with a comprehensive Benefit Package including Paid Time Off (PTO), Health, Vision, Dental and 401K with match.

General Summary:

Under general supervision, follows established collection procedures in pursuing final payment of delinquent patient accounts. Reviews payment records to ensure that insurance carriers were billed correctly. Confers with insurance companies, agencies, and public assistance agencies regarding patient claims.

PRINCIPLE DUTIES AND RESPONSIBILITIES:

• Performs follow-up duties to ensure prompt payment from assigned payers following policies and procedures.
• Reviews payment listings for accurate payment and rejections, insuring that proper contractual adjustments are posted to accounts.
• Confers with insurance agencies regarding payment delays, denial of claims for payments that differ from verified accounts (shortages)
• Clarifies hospital services rendered and provides support documentation as needed to justify third party payment.
• Determines whether accounts are eligible for payment, prepares corrected rebill and processes for mail.
• Follows all HIPAA (Health Insurance Portability and Accountability Act) rules and regulations.
• Interacts courteously and compassionately with other associates.
• Communications with patients, visitors and clients are friendly and professional.
• Maintains a professional appearance.
• Projects a positive image in the community.

Other duties as assigned.

SPECIAL SKILLS AND ABILITIES REQUIRED:

• Analytical/clerical ability to review computerized reports and determines balances, prepare appeal letters, correct claims and provide support documentation as needed.
• The interpersonal and communication skills necessary to frequently interact with insurance agencies.
• The mathematical ability to compute accounts, forecast payment schedules, etc

KNOWLEDGE, PRACTICAL EXPERIENCE AND LICENSURE/REGISTRATION REQUIRED:

• The level of knowledge equivalent to completion of high school or GED.
• One year of experience in order to learn appropriate collection procedures and techniques to become familiar with billing procedures and to acquire suitable interpersonal skills.
• An understanding of integrated data processing billing systems and the ability to entry data.
• Knowledge of HIPAA rules and regulations and the ability to apply these regulations on a daily basis.

WORKING CONDITIONS:

The above statements are intended to describe the general nature and level of the work being performed by people assigned this job. They are not exhaustive lists of all duties, responsibilities, knowledge, skills, abilities, and working conditions.