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Baptist Memorial Health Care · 6 hours ago

Specialist-Accounts Receivable Follow Up

Jackson, MS

Full-time

Onsite

Entry Level

1+ years exp

Baptist Memorial Health Care is a healthcare organization seeking an Accounts Receivable Follow Up Specialist. The role involves performing collection and follow-up activities with third-party payers to resolve outstanding balances and ensure timely adjudication of accounts receivable.

GovernmentHealth CareHospitalMedicalNon ProfitNursing and Residential CareRehabilitationWellness

Responsibilities

Performs online account status checks and contacting payers to follow-up on outstanding claim balances of assigned accounts in work queues

Clearly documents in EMR system the patient account notes, the payment status of the account, and/or actions taken to secure payment. If applicable, requests account for additional follow up activity within a prescribed number of days in accordance with payer specific filing requirements or processing time required for insurance to complete processing

Performs required actions to resolve the account balance promptly by submitting appeals, correcting account information, coordinating requests for medical records, requesting and/or performing posting of account adjustments, requesting an account rebill and any and all other actions necessary to secure account payment and/or bring the account to successful closure

Documents, tracks, and ensures a reasonable turnaround time of receipt of any outstanding documents required from external departments

Responds to claim denials from payers such as inability to identify the patient, coordination of benefits, non-covered services, past timely filing deadlines, and ensures all information is provided to the payer

Documents all actions taken on accounts in the EMR system account notes to ensure all prior actions are noted and understandable

Informs the supervisor of any problems or changes in payer requirements and exercises independent judgment to analyze and report repetitive denials to take appropriate corrective action

Achieves established productivity and quality standard as determined by the Baptist Productivity and Quality Expectations Documentation

Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact patient account collections. Adheres to internal controls for applicable state/federal laws, and the program requirements of accreditation agencies and federal, state and private health plans

Seeks advice and guidance as necessary to ensure proper understanding

Effectively utilizes payer websites as needed in the execution of daily tasks

Conducts account claim status and follow up and resolves claim payment denials

Monitors assigned work queues at all sources and ensures expeditious resolution while working with other departmental representatives in resolution

Reports unresolved issues and concerns impeding the collection process and to ensure successful account resolution

Complies with patient confidentiality policies for the retention of patient health information, or when handling, distributing, or disposing of patient health information

Performs other duties as assigned by the Supervisor

Qualification

Insurance billing knowledgeAccounts receivable managementHealthcare experienceMicrosoft Office proficiencyICD-9ICD-10 knowledgeCustomer service skillsProblem solvingWritten communicationOral communication

Required

Experience in the healthcare setting or educational coursework

PC skills and keyboarding Working knowledge of 10 key, typing and computers. Proficiency in Microsoft Office

Ability to type and key accurately, problem solving, written and oral communication skills, financial counseling skills - knowledge of insurance billing (both hospital and professional settings) and collections - knowledge of insurance guidelines as it relates to CMS guidelines, TennCare and/or Medicaid based by state specified requirements. Ability to recognize and communicate to clinical staff or designee when insurance companies require additional review because of NCCI, CCI, LMRP, Mutually Exclusive and Medical Necessity edits. Effective Verbal, written and customer service skills as it relates to patients and insurance companies. Able to create communications to patients and insurance companies as needed to resolve issues to complete billing/claim processes

Preferred

One (1) year experience in physician's office or hospital setting

Knowledge of insurance billing and collections and insurance guidelines

Knowledge of ICD-9, ICD-10, CPT and HCPCS codes and certification and/or degree in Healthcare Administration Business, Finance or related fields preferred