Full job description
A Remote Insurance Follow-Up Representative (Medical) will be responsible for all collection functions for hospital
and physician services. This primary responsibility of this position is account resolution which includes the following duties: reviewing accounts, following up with Medical and various insurance companies on claim status, gathering and submitting any missing information, rebilling, appeals, and billing out secondary electronic or paper claims to all payers as needed.
Duties/Responsibilities
- Provide customer service to various healthcare contract customers
- Prepare, research and collect from Medi-Cal and various contracted health insurance payers
- Research remits and Explanation of Benefits (EOBs) for complete accurate payments or denials
- Provide or arrange for additional information when needed
- Submit corrected claims or appeals
- Request appropriate adjustments, when required
- Identify items that require client assistance
- Gather payor trends and provide feedback
- Other duties as assigned
Required Skills/Knowledge
- Medi-Cal experience required
- EPIC experience preferred
- Microsoft Office
- Knowledge in government and non-government billing guidelines for facility/physician
- Knowledge in account/claim status, resolution, and appeals process
- Knowledge of the UB04 and HCFA forms
- Excellent customer service and time management skills
- High attention to detail required
- Excellent verbal, written, and electronic communication skills required
Education/Experience
- High school diploma or General Education Development (GED) certificate required
- One to Two years of college preferred
- Minimum of three years of experience preferred
- Prior medical billing and insurance collections or healthcare revenue cycle experience preferred
