Medical Insurance A/R Follow-Up Specialist
- 10888 S 300 W, South Jordan, UT 84095, USA
Guardian Flight is a leading provider of air medical services, management, and experience in the air medical industry. Guardian Flight has developed a proven business model that allows our programs to experience success in caring for and transporting patients in rural area hospitals to large tertiary care facilities in metropolitan areas. We utilize the most advanced equipment, quality aircraft, and most importantly, trained and experienced staff to accomplish our mission of saving lives and caring for the communities we serve.
The Medical Insurance A/R Follow-Up Specialist 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 of resolving Insurance Denials and collecting on Accounts Receivable. All tasks must be performed in a timely and accurate manner in accordance with Billing Office practices, policies, and procedures.
MAJOR DUTIES AND RESPONSIBILITIES:
- Complete follow-up of claims on a timely basis according to the productivity guidelines for account follow-up goals
- Meets daily and monthly departmental production goals set forth by the Supervisor to ensure that the company is achieving its financial goals.
- Reviews and analyzes claim denials in order to perform the appropriate appeals necessary for reimbursement.
- Submits appeals with supporting documentation according to the payer-specific denial reasons and procedures.
- Proactively works with Supervisor to develop appeal strategies where challenges arise.
- Identifies, documents, and communicates trends in recurring denials. Recommends process improvements or system edits to eliminate future denials
- Pursue unpaid accounts by telephone or electronic inquiry to determine status of payment in accordance with department follow-up timelines
- Provide feedback to management regarding any patterns of payer denials or repetitive insurance verification, coding, or billing errors that may be encountered during AR follow-up.
- Review system generated work list and aged reports to resolve accounts which have not been paid in the appropriate time frame, based on payer contracts and guidelines
- Review payment denials and discrepancies identified through EOB, Remittance advices or Payer correspondence and take appropriate action to correct these accounts
- Comprehensively document all account activity in an accurate and timely manner for all touches made on any patient account
- Make inquiries via telephone, mail, and fax or electronically through payer website or e-mail for follow-up of those unresolved accounts
- Contact patient for additional information when necessary to push the claim through for payment
- Resubmit claims to payers as necessary, via electronic, fax, or hard copy
- Other duties as assigned
- 1+ years of experience collecting Accounts Receivable from Insurance, Medicare, or Medicaid in the medical provider industry.
- High School education, prefer some college or specialty training in medical billing or equivalent job relevant experience.
DEMONSTRATED JOB-RELATED SKILLS/COMPETENCIES:
Successful candidate will be able to work independently and in a fast paced team environment, have the experience to operate multiple computer applications, have strong experience with Microsoft Word and Excel, be able to communicate verbally and in writing, and perform at a high quality in a high volume setting. Most importantly, he or she must possess the skills to accurately analyze and research complex patient accounts, thus leading to the appropriate actions to resolve the account in a professional manner.
PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS
- Regularly required to reach with hands and arms; speak and hear
- Frequently required to sit for long periods of time
- Occasionally required to stand and walk
- Talk/hear – must be able to communicate, detect, converse with, convey, express oneself, exchange and process information independently
- Adequate concentration/Memory skills
- Ability to comprehend and understand information
- Ability to take constructive feedback
- Meet project deadlines
- Interpersonal communication skills
- Ability to apply good judgment
- Decision making
- Ability to take direction
For more information, visit www.amrg.com/careers