Medical Billing – Revenue Cycle Follow Up Specialist
On-Site or Remote
Starting Pay $19.50
The BCBS Follow-up Specialist supports the functions of the Revenue Cycle team by assisting in the review and interpretation of EOBs and Remits from the Payor. Applicants must have experience working with one or multiple payer sources, such as Medicare, Medicaid and Commercial insurances. The successful candidate will possess a strong attention to detail, have effective communication skills as well as a proven track record resolving Insurance Denials and collecting on Accounts Receivable.
Essential Functions/Duties
· Review Explanation of Benefits, denial letters and payor correspondence to determine next steps.
· Compare and review fee schedules with insurance payments/decisions to verify if claim has been paid according to contract.
· Identify, document and communicate trends in recurring denials and incorrect payments; recommend process improvements or system edits to eliminate future denials or underpays.
· Pursue unpaid accounts by telephone or electronic inquiry to determine the status of payment in accordance with department follow-up timelines.
· Comprehensively document all account activity in an accurate and timely manner for all touches in billing software.
· Use reports to manage daily workflow and ensure accounts are processed within required timeframes.
· Meet daily and monthly departmental production goals to ensure the company is achieving its financial goals.
· Other duties as assigned.
Education
· High School Diploma or equivalent; prefer some college or specialty training in medical billing or equivalent job relevant experience.
Skills
· Knowledge of health care billing procedures, reimbursement, third party payer regulations, documentation, and standards. Knowledge of Blue Cross Blue Shield payors is a plus.
· Strong problem-solving skills, attention to detail, and ability to make timely decisions.
· Excellent internal and external customer service skills.
· Responsiveness and a strong commitment to meeting internal and external deadlines with limited supervision.
Qualifications/Required Experience
· Must be fluent in English
· Minimum of one (1) year of advanced medical billing experience; experience with BCBS insurance a plus
· Professional written and verbal communication skills
· Knowledge and experience of computers and related technology; using multiple applications at one time
· Ability to work independently with little or no direction and as a member of a team
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