Pa Follow Up Clerk

The PA Follow-Up Clerk is responsible for the timely follow-up and account resolution of all claims. Follow up Communicates with patients, intermediaries and Federal agencies, safeguarding the public relations of the hospital by consistent professional conduct.
1. Identifies and Follow Up on any unpaid account(s) in a timely manner to assure prompt payment from payers and patients and prevent aging of Accounts Receivable.
2. Follow-up staff must continuously identify issues or repetitive errors, which impede the bill generation process. Provides feedback to the Production Biller, as a quality assurance (QA) tool, to ensure accurate billing and minimize delays on reimbursement.
3. Processes accurate adjustments, write-offs, account reclassifications on claims including but not limited to denials.
a) Researches any incorrect payments, as identified through the Remittance Advice or through follow-up.
b) Processes all correspondence, i.e. mail backs, rejections and inquiries.
4. Follow-up staff productivity shall aim to work 50 accounts per day at a minimum, on average. This includes correspondence, and electronic rejections (NEIC, etc.) received and daily work queue accounts.
5. Keeps an accurate record on all patients under scope of responsibility, which includes keeping accurate information on account activity; provides appropriate file documentation as needed to maintain accurate records on patients’ account financial status.
6. Responsible for being familiar with regulatory changes issued by intermediaries and insurance companies to determine how charges could impact claims processing and communicates with Supervisor such changes.
7. Demonstrates a thorough knowledge and understanding of billing and follow-up policies and procedures in performing job duties and instructing patients and hospital personnel. Routinely uses Patient Accounting Policy and Procedure Manual and other reference materials as necessary to ensure the proper course of action in insurance follow-up and collection.
8. Responsible for providing feedback to the Department Director and/or manager as to the accuracy of the HIS Service Master based on accurate coding as it impacts billing and reimbursement.
9. Responsible for reporting the status of all accounts under scope of responsibility. This includes the timely response to all requests and inquiries by the Department Supervisor or Director.
10. Utilizes systems under scope at its full capacity. Continues to grow in the user of the computer system as its capabilities expand.