[Hiring] AR Commercial Follow Up Specialist @UofL Health

Role Description

This position requires thorough knowledge of the Uniformed Bill, timely filing limits set forth by various payers, and various payer websites for follow-up. Performs all duties related to timely and efficient billing and follow-up. Thorough understanding of commercial payer eligibility, benefits, determining primary payer, and covered benefits. Understanding of billing policies for auto and worker’s compensation as well as incarcerated patient payers.

• Monitor commercial and specialty payer accounts receivable inventory to ensure timely follow-up and claims resolution.
• Adhere to quality and productivity standards assigned by management.
• Submit account for appeal on accounts where retroactive coverage has been obtained.
• Identify payers being submitted on paper rather than electronically and communicate the opportunities to leadership.
• Follow up on unpaid commercial and third-party payer claims in a timely manner.
• High dollar accounts will have consistent follow-up until the account has been resolved.
• Responsible for reviewing and understanding explanation of benefits/remittance advice.
• Ensure statements are generated for the patient responsibility amounts.
• Utilize insurance websites to view and resolve claims.
• Perform extensive account follow-up and provide analysis of problem accounts.
• Document all follow-up efforts in a clear and concise manner into the AR system.
• Compliance with State and Federal Regulations.
• Audit, research accounts, payment posting, contractuals to confirm the accuracy of the balance of the account.
• Ensure medical record requests are documented and submitted in a timely manner.
• Collaborate with denials team on difficult or reoccurring denials.
• Complete tasks by deadline.
• Identify and report all trends that may provide insight into payment challenges.
• Phone contact with patient, physician office, attorney, etc. for additional information to process the claim.
• Attend seminars as requested.
• Other duties as assigned.

Qualifications

• High School Diploma, or GED
• 1 year of patient registration, billing or equivalent experience
• Working knowledge of medical and insurance terms is desirable.

Requirements

• Ability to review, comprehend, discuss HCFA billing with Insurance or Government agencies.
• Knowledge of general insurance requirements.
• Experience working directly with EOBs and contractual adjustments.
• General computer knowledge, working with electronic filing.
• Ability to communicate verbally/in writing with professionalism.
• Ability to meet productivity expectations.