Claims Follow Up Representative

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Claims Follow UpRepresentative

A well-known company in the Healthcare industry is looking for a Claims Follow Up Representative to join their team!

The right candidate must have accounts receivable follow up experience, billing knowledge, strong Excel and customer service skills. This position is responsible for effective accounts receivable management of outstanding claims. In addition, will routinely research and effectively perform follow-up on unpaid claims, denials, and tracers. This positions works with insurance companies to resolve patient billing /carrier issues to ensure expected payment and analyze and resolve credit balance accounts.

A. Processing Claims

  • Collections, must do 25 applications an hour
  • Process eligibility verifications, new day claim processing (including reports and attachments) and EOB retrieval
  • Research and follow up on unpaid claims, denials, tracers and demand claims
  • Audit accounts to determine accuracy of charges and adjustments
  • Responsible for resolving claim issues
  • Sort and process tracer responses
  • Support the day to day unit process
  • Understand the roles and responsibilities of the Unit
  • Perform BMI Searches and request appropriate documentations

B. Customer Service

  • May work with external clients, insurance companies and customers to resolve patient billing issues
  • Discuss patient accounts with internal and external customers in a calm, logical and rational manner
  • Maintain records of communication and work files

  • Work collectively in a professional manner
  • Adhere to the organizational policies and procedures and support the initiatives.
    • Demonstrate commitment to the values and compliance with the policies and procedures.
    • Compliance with HIPAA--demonstrate a clear understanding of and consistently adhere to all applicable regulations, ensure Protected Health Information (PHI) information is used in an appropriate manner and in compliance with HIPAA policy. This position may permit the incumbent access to clinical, financial, demographic or billing PHI as defined in the HIPAA.

    • Requirements

    • Education:
      High school diploma or GED
    • Experience:
      2 plus years at a health care facility in a business office
    • Skills:
      The right candidate will have training in the following IDX classes: BAR Registration, BAR payment posting, BAR inquiry, claim forms, rejection reporting and must have knowledge in Word and Excel.
    • Must communicate effectively with others, perform basic mathematical calculations, possess basic clerical experience and prepare correspondence utilizing proper syntax, grammar and punctuation. Ability to work well in a team environment, ability to maintain confidentiality, ability to multi-task, produce quality work and meet deadlines in a fast paced environment.
    • Must pass drug screen and background check
    • Must provide two supervisory references
    • Must provide proper identification to verify eligibility to work in the US


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