Insurance Follow up Rep

Location: Little Rock, Arkansas
Date Posted: 07-12-2018
 Essential Functions
  • Works assigned work queues in the Revenue Cycle and Revenue Manger systems on a daily basis.
    • Processes claims as needed by accurately attaching the appropriate primary EOB prior to submission.
    • Accurately codes insurance information on coverage records in Revenue Cycle system.
    • Maintains work queues generated by electronic submission of claims, correcting errors and reprocessing claims as needed.
    • Provides follow-up of unpaid (or incorrectly paid) claims as dictated by department policy.  Submits corrected claims as needed and processes appeals for incorrectly denied claims.  (Processes write-offs as needed and as dictated by department policy.).
    • When available, processes on-line adjustments to insurance claims.
    • Complies with audit requests by insurance carriers in a timely fashion.
    • When necessary, reviews medical records and resubmits claims with appropriate documentation to expedite claims processing (adhering to confidentiality requirements).
    • Accurately processes corrections on accounts and/or active claims by error correcting or voiding transactions as indicated in department policy.  Posts appropriate adjustments as needed. 
 Qualifications:
  • Required:
    • High school diploma or GED.
    • Proficient in the use of basic computer applications and Electronic Medical Records
    • Must be a team player.
    • Maintains a positive, resourceful attitude toward achieving overall department and clinic goals
    • Knowledge of ICD-10, CPT coding, medical terminology, and insurance billing.
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