Insurance Claims Representative

Alabama Oncology

Insurance Claims Representative

Birmingham, AL
Full Time
Paid
  • Responsibilities

    This is an on-site position located at the Birmingham Business Office

    Summary: Under general supervision, an AR Account Follow-Up Specialist is responsible for account follow-up for all assigned accounts, resolving billing problems and answering patient inquiries. Uses collection techniques to keep accounts receivable current including monitoring for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take appropriate action including completion of submissions, reconsiderations, appeals, and denial management to ensure payment is received timely.

    Essential Duties and Responsibilities:

    • Performs audits of patient accounts to ensure accuracy and timely payment.

    • Follows up on insurance billing to ensure timely receipt of payments.

    • Demonstrates the ability to deal with patients and insurance companies regarding sensitive financial matters and recapture unpaid balances.

    • Receives and resolves patient billing complaints and questions; initiates adjustments as necessary; follows up on all zero payment explanations of benefits and exercises all options to obtain claim payments.

    • Reviews credit balance reports for correct recipient of refund.

    • Performs reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks.

    • Identifies problems on accounts and follows through to conclusion.

    • Responds to insurance companies requests for information in a prompt and professional manner.

    • Reviews EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends to supervisor.

    • Prepares write-off requests with appropriate documentation and submits to supervisor.

    • Processes insurance/patient correspondence.

    • Works with provided aging to monitor patient account aging and follows up appropriately.

    • Maintains confidentiality in regard to patient account status and the financial affairs of clinic/corporation.

    • Other relevant duties as assigned

    • Demonstrated knowledge of the federal, state, and local regulatory requirements around medical billing and coding as well as CMS and payer regulations.

    • Ability to work independently.

    • Able to manage multiple projects at once working efficiently and effectively under tight deadlines.

    • Experience with oncology billing experience highly desirable.

    Requirements

    • High school diploma

    • 1 plus years of experience

    • Experience in medical billing /insurance processing and balancing accounts