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Tucson Medical Center · 3 weeks ago

Billing Follow Up Representative

Tucson, AZ

Full-time

Onsite

Mid Level

3+ years exp

Tucson Medical Center is dedicated to ensuring efficient handling of all insurance billing and collection activities. The Billing Follow Up Representative will communicate with insurance companies, maintain effective public relations, and ensure timely billing and follow up on patient accounts.

Health Care

Responsibilities

Ensures the efficient handling of all insurance billing, follow up and collection activities

Communicates with insurance companies and state agencies

Possesses strong knowledge of payer contracts and demonstrates complete understanding of payer billing requirements to ensure timely and accurate payment

Completes reconciliation and billing of accounts making independent decisions based on payer, coding and billing guidelines

Exhibits excellence in customer service through appropriate attitude and interaction with all customers, insurance plans, patients, visitors and staff

Maintains and fosters effective public relations with patients and public

Adheres to and supports team members in exhibiting TMCH values of integrity, community, compassion, and dedication

Assists management in maintaining or reducing account receivable (AR) days to meet industry standards and improve organizational cash flows

Ensures patient accounts are billed and followed up on timely in a complete and accurate manner in accordance with payer contracts or guidelines

Provides information regarding patient accounts in response to inquiries, safeguarding confidential information in verbal replies and correspondence

Prepares and enters contractual write offs as identified

Serves as information resource to patients and hospital staff regarding insurance claims

Provides routine internal and external interface with internal and external department staff and insurance payers, in order to resolve insurance related accounts

Assists with problem solving, inquiries, and customer interaction to ensure positive results

Analyzes patient accounts, reviews explanation of benefit and payer remits

Analyzes and processes contractual write offs as needed

Trains and assists in the implementation of new software programs/systems, system upgrades and related technologies

Responds to insurance inquiries/requests as received either by mail or electronically

Ensures all billing edits are completed daily for claim submission

Adheres to TMCH organizational and department-specific safety and confidentiality policies and standards

Performs related duties as assigned

Qualification

Medical billing knowledgeInsurance follow-up experiencePayer contractsMedical terminologyComputer applications proficiencyCustomer service skillsOrganizational skillsProblem-solving skills

Required

High School diploma or General Education Degree (GED); or an equivalent combination of relevant education and experience

Three (3) years of related experience such as medical billing, medical insurance follow up in a physician or hospital setting

Knowledge of medical insurance practices and policies and regulations

Knowledge of fields on UB/1500 claim forms

Knowledge of government and non-government uniform billing guidelines

Knowledge of medical terminology and coding Related to hospital billing and/or professional billing such as revenue, CPT diagnosis codes and modifiers

Skill in evaluating bills/claims for payers or patients in order to collect payment in a timely manner

Knowledge of resolving payer claim edits and rejections

Possesses and maintains knowledge of current regulatory and third party payer requirements to support billing reimbursement

Skill in providing assistance or training to other staff members in a team environment

Skill in the use of computer applications and systems including: Excel, Word, Internet, email, and miscellaneous programs and networked computer systems

Ability to read and comprehend instructions, short correspondence, and memos

Ability to write correspondence; ability to effectively present information in one-on-one and small groups situations to customers, clients, and other employees of the organization

Ability to read and interpret documents such as safety rules, procedure manuals, and governmental regulations

Ability to meet productivity and quality review standards

Good organizational skills, adaptable to changes and ability to prioritize workload

Ability to function well under stress and handle high volumes of work

Ability to effectively present information and respond to inquiries or complaints from payors, patients and/or their representatives

Ability to calculate figures and compute reimbursement rates, and interpret bar graphs

Ability to apply common senses understanding to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists