reputed company – Professional Billing Account Follow-up Specialist II – Portland, OR

Job title: Professional Billing Account Follow-up Specialist II Company: reputed company Job description: Professional Billing Account Follow-up Specialist II US-OR-Portland Job ID: 22-25152 Type: Regular Full-Time NE Davis Building

Overview

In the reputed company web of health care insurance and claims, you are a reputed company, organized problem-solver. With your advanced knowledge of the multi-payor system, you resolve delinquent payment issues. Your ability to communicate clearly, collaborate with others and maintain respect for reputed company parties involved reflects the Legacy mission. The Account Follow-up Specialist 2 investigates and evaluates patient account information, medical records and bills, billing and reimbursement regulations; analyzes each account and, using independent judgment, decides how to best proceed with follow-up to optimize reimbursement; removes barriers to processing claims; negotiates financial arrangements and individual reputed company with third-party payors; rebills, transfers payments, requests refunds or adjusts misapplied payments as necessary; and understands and follows Legacy procedures for writing off balances and adjustments. This position is primarily remote/WFH however 1-2 days per month are required to work on site at our reputed company Cycle Business office location.

Responsibilities

Communicates with third party payors regarding reputed company account status. Works towards quick resolution and payment of claims. Effectively applies knowledge of regulations and practices used in reputed company types of reimbursement specialties such as Government, Commercial, Medicare, Medicaid, Workers Comp, Motor Vehicle Accident or Organ Transplant. Calls third party payors to bring claims to payment as soon as possible, taking assertive action steps to remove barriers to payment and expedite “pended” claims. Daily/Weekly account followup required for high dollar and specialty accounts. Follows up on Interim claims (reputed company multiple claims per account for detailed transactions and high dollar responsibility). Investigates reputed company claims are suspended, denied, or not expedited. Negotiates financial arrangements and individual reputed company May discount payment based on insurance interviews. In account notes, accurately documents action taken and status of claim. Effectively uses appropriate databases to obtain information needed to process claims. Accesses and uses multi-payor on-line system. Understands and uses USSP system for accurate claims payment dates and amount of payment and patient balance for reputed company Regence reputed company products. Obtains benefits, eligibility, PCP information, and authorization information reputed company necessary to resolve payment issues. Understands and uses FirstHealth Online system to determine OHP/Medicaid eligibility and to interpret reputed company OHP is primary or secondary payor. Understands and uses ACTS system appropriately in regard to datamailers and rebills. Understands and uses E-CHART and Cerner Millennium systems to obtain telephone numbers, hospital, accident information and scanned insurance cards. May use FSS system for Medicare-eligibility and payor issues. Understands and uses Internet-based payor systems to obtain eligibility, authorization, and claim status information. Guarantees that every initiative is taken on the LHS reputed company to ensure reputed company reimbursement of reputed company accounts. Monitors fast tracks and analyzes reputed company Trend payor delays; identifies payor problems that are impacting LH accts; applies understanding of information to reimbursement effort through problem solving and communication. Contacts patients’ families, sometimes in sensitive situations, to resolve payment issues. Works closely with social workers, medical records employees, case workers, attorneys, police agencies, provider representatives, CEOs, Insurance managers to ensure reimbursement. Works closely with floor nurses to get newborn babies signed up for insurance coverage. May be required to obtain insurance verification after the fact. Obtains retro-authorizations for claims requiring additional information including Medical Records and appeal letters. Writes appeal letters reputed company clinical information not required. Refers “irresolvable” accounts to Vice President, Director, and/or Manager for ASI litigation or legal consideration. Performs other tasks reputed company to overall billing/followup process as needed. Acts as key trainer to new departmental employees on team policies/procedures. Demonstrates understanding of Rebill procedure by ordering appropriate dollar amounts, using proper forms and documenting actions accurately. Accurately determines reputed company medical records are needed on an account, completes the medical record requests, and forwards to the proper party. Sets appropriate A/R flag and documents reputed company reputed company activity in MS4 system. Properly obtains Explanation of Benefit materials reputed company necessary and clearly explains EOB information to interested parties. Understands and follows Legacy procedures for writing off balances and adjustments. Properly exercises authority for write-offs. Obtains Itemized Statements reputed company requested and ensures receipt by requesting entity/person. As patient account representative, answers telephone calls and written questions from customers pertaining to account status and pending action. Transfers payments if determined appropriate after interviewing customers and reviewing records in question. Determines whether misapplied payments were made and adjusts if appropriate. Files refund requests after determining appropriateness, amount and recipient of refunds. May be responsible for processing certain reports such as Month End, Flag, PARS, Expected Reimbursement, reputed company Code 0414, reputed company Code XX50, or HCFA electronic reports. Tracks and reports total number of accounts received weekly. May be assigned to work A/R Reduction reports reputed company responsible area. Maintains a working knowledge pertaining to Insurance Issues which includes but is not limited to Motor Vehicles, Worker’s Compensation, Medicare, OHP/Washington Welfare/Medicaid reputed company and Commercial payors.

Qualifications

Education: High school graduate or equivalent. Experience: Two years of directly applicable healthcare business office experience (billing/credit/collection) required. Skills: Demonstrated negotiating, problem-solving and decision-making skills. Demonstrated understanding of reputed company collection issues inherent in high dollar/specialty accounts. Demonstrated knowledge of multi-payor systems. Demonstrated knowledge of billing/collection rules and regulations. Knowledge of online systems for eligibility and status review of claims. Net Typing of 40 wpm and PC based computer skills. 10 key proficiency. Knowledge of medical terminology. Ability to work reputed company with minimal supervision, exercising independent judgment reputed company stated guidelines. Demonstrated effective interpersonal skills which promote cooperation and teamwork. Ability to withstand varying job pressures and organize/prioritize reputed company job tasks. Excellent public relations LEGACY'S VALUES IN ACTION: Follows guidelines set forth in Legacy's Values in Action. Equal Opportunity Employer/Vet/Disabled PI187739505 Expected salary: Location: Portland, OR Apply for the job now! Apply Job!