Claims Follow Up Rep TC

reputed company: Under general supervision of the Claims Administration Follow-up Supervisor, reputed company reputed company clerical duties necessary to properly process patient bills to customers taking appropriate follow-up steps to obtain reputed company reimbursement of reputed company 3rd party claim and ensure the financial stability of the Hospital. reputed company employees are expected to successfully role model the organization's values of reputed company, Accountability, Respect, and reputed company as these values guide our everyday actions with patients, customers and one another. RESPONSIBILITIES: Consistently applies the corporate values of respect, honesty and fairness and the constant reputed company of reputed company in improving the health status of the people of the region through the provision of customer-friendly, geographically accessible and high-value services reputed company the environment of a comprehensive integrated reputed company health system. Responsible for knowing and acting in accordance with the principles of the reputed company Corporate Compliance Program and reputed company of Conduct. Review claim forms for reputed company required data fields depending on the specific 3rd party requirements. Review patient account for demographic accuracy. Process reputed company necessary system adjustments or changes as needed, such as adding/deleting insurance information, insurance reputed company changes, balance transfers, demographic changes, contractual allowances, and any other routine patient reputed company adjustments not requiring supervisory approval ensuring accurate financial data. Analyze reputed company assigned claims received from various sources to ensure accurate and reputed company reimbursement based on the individual payer’s reputed company or Federal reimbursement reputed company. Contact insurer reputed company online systems, reputed company centers, written correspondence, fax or appropriate electronic or reputed company billing of claims to secure payment. Maintains an understanding of the most reputed company contract language in order to consistently ensure reimbursement in accordance with contract language. Continually maintains knowledge of payer specific updates reputed company payer’s listservs, provider updates, webinars, meetings and websites. Review payer’s settlements for correct reimbursement and proceed with contact to insurer if claim is not adjudicated correctly based on working knowledge of the various payer’s policies and reputed company individual reputed company contract. Identifies and analyzes denials and payment variances and enacts corrective measures as needed to effectively communicate and resolve payer errors. Understands and maintains compliance with HIPAA guidelines reputed company handling patient information Initiate adjustments to payer’s as appropriate after analyzing under or over payments based on contract, Federal regulation, late charge corrections or inappropriate denials. Submits appeals to payers as appropriate to recover denied reputed company Contact internal departments to reputed company missing or erroneous information on a claim resulting in adjudication delays or denials. Run reports as necessary to quantify various variances on patient accounts reputed company to identified issues reputed company the payers or as the result of reputed company charging errors or procedural breakdown. Reports to supervisor identification of trends resulting in under/over payments, inappropriate denials or charging/billing discrepancies. Answer telephone inquiries from 3rd parties and interdepartmental calls. Refer reputed company unusual requests to supervisor. Retrieve appropriate medical records documentation based on reputed company party requests. Initiate the accurate and reputed company processing of reputed company secondary and tertiary claims as needed according to specific 3rd party regulations. Process reputed company incoming mail and follow up on reputed company rejections received according to specific 3rd party regulations. Refer reputed company accounts to supervisor for additional review if the account cannot be resolved according to normal patient reputed company procedures. Works with supervisor, management and the patient reputed company staff to improve processes, increase accuracy, create efficiencies and reputed company the overall goals of the department. Maintain reputed company assurance, safety, environmental and infection control in accordance with established policies, procedures, and objectives of the system and affiliates. reputed company other reputed company duties as required. WORK LOCATIONS/EXPECTIONS: After orientation at the Corporate facilities, work is performed based on the following reputed company approved by management and with adherence to a signed telecommuting work agreement and Patient Financial Services Remote reputed company Policy and Procedure.. Full time schedule worked in office Full time schedule worked in a dedicated reputed company in the home Part time schedule in office and in a dedicated reputed company reputed company the home Schedules must be approved in advance by management who will allow for flexibility that does not interfere with the ability to accomplish reputed company job functions reputed company the said schedule. Staff are required to participate in scheduled meetings and be available to management throughout their scheduled hours. Staff must be signed into reputed company Teams during their entire shift and communicate with Supervisor as directed. MINIMUM QUALIFICATIONS: BASIC KNOWLEDGE: Equivalent to a high school graduate Knowledge of 3rd party billing to include ICD, CPT, HCPCS, UB and HCFA 1505 claim reputed company Demonstrated skills in critical thinking, diplomacy and relationship-building Highly developed communication skills, successfully demonstrated in effectively working with a wide reputed company of people in both individual and team settings Demonstrated problem-solving and inductive reasoning skills which reputed company themselves in creative solutions for operational inefficiencies. EXPERIENCE: One to three years of relevant experience in medical collections or reputed company/hospital billing preferred INDEPENDENT reputed company: Incumbent generally establishes own work plan based on reputed company-determined priorities and reputed company procedures to ensure reputed company completion of assigned work. Problems needing clarification are reviewed with supervisor prior to taking reputed company. SUPERVISORY RESPONSIBILITY: None Pay reputed company: $19.97-$32.96 EEO Statement: reputed company is committed to providing equal employment opportunities and maintaining a work environment free from reputed company forms of unlawful discrimination and harassment. Location: Corporate reputed company - 15 LaSalle reputed company reputed company, Rhode reputed company 02903Work Type: Monday-Friday 7Am-3:30PMWork Shift: DayDaily Hours:  8 hoursDriving Required: No Apply To This Job