Job Summary

Responsibilities include follow-up performed on insurance and or third party account receivables to ensure payment is received from the insurance company within federal, government timelines. Communicates clearly and efficiently by phone and in-person with insurance companies, clients. Patients, and staff members. Maintains productivity standards and submit required daily reports which also includes top 20 weekly report and daily productivity tracking report. Obtains updated demographic information and all necessary information needed to comply with insurance billing requirements. Responsibilities also include utilizing a follow-up matrix to ensure timely follow-up on aged receivables. Work denial and rejection report daily in their entirety. Complete cash report review to resolve all residual balances owed by primary, secondary, tertiary, and or patient. Document accounts with clear and concise notes as it relates to following up. Request rebills when necessary and work with other internal departments as it relates to coding, registration, and other ancillary services. Quality assurance results should be greater than 90% on a monthly basis to ensure proper follow-up on assigned inventory. Other duties as assigned or needed.

Demonstrates Competency in the Following Areas

• Strong interpersonal/public relations skills.
• Ability to work effectively with a wide range of customers in a diverse environment.
• Knowledge of Medicare, Medicaid, Commercial and HMO payers.
• Ability to perform analytical problem-solving.
• Ability to perform basic math.
• Ability to operate concurrently within a variety of hospital systems.
• Working knowledge of PC applications, Word, Excel, etc.
• Keyboarding skills.
• Knowledge of organizational structure, workflow, and operating procedures.
• Strong oral and written communication skills.
• Organization and time management skills.
• Ability to follow directions and establish priorities effectively.
• Self-directed and capable of working without direct supervision.
• Dependable in both production and attendance.
• Demonstrates the ability to be flexible, organized, and function well under stressful situations.
• Maintains performance improvement activities for the department.
• Documentation meets current standards and policies.
• Provides education to staff on performance improvement. Ability to plan and organize orientation and in-service training for department staff members. Participates in guidance and educational programs.
• Performs management activities including interviewing, hiring, evaluating, termination, and departmental staffing scheduling.

Regulatory Requirements

• High school graduate or equivalent required.
• Preferred post-secondary education, i.e., Associate Degree in healthcare or business-related field.
• Bilingual capability (English/Spanish) desired.