JOB SUMMARY
The Patient Financial Services Follow-up Specialist will be responsible for maintaining follow-up functions within the department
ESSENTIAL FUNCTIONS
- Examines and manages underpaid and overpaid claims to determine reasons for discrepancies.
- Communicates directly with payers to follow up on outstanding claims, resolve payment variances, and achieve timely reimbursement.
- Works and monitors daily follow-up queues assigned.
- Resolves and follows up on challenging, problematic, and unresponsive accounts as necessary; escalates critical or ongoing issues to Supervisor.
- Analyzes data to track collection efforts, identify trends, and provide team with updates and ideas for improvement.
- Maintains a thorough understanding of rules, regulations, and requirements specific to billing in order to promote compliant claims submission practices.
- Observes best practice processes in billing, follow-up and customer service activities.
- Collaborates with leaders and staff to improve processes, increase accuracy, create efficiencies, and achieve the overall goals of the department.
- Thoroughly documents all interactions with payers.
- Performs general Business Office duties.
- Completes other tasks and projects as assigned.
Required Skills
ORGANIZATIONAL EXPECTATIONS
- Proficiency in Microsoft Word and Excel.
- Knowledge of payer policies, regulations, and the legal environment within which they operate.
- Ability to investigate and analyze information and draw conclusions on complex issues.
- Ability to work on multiple projects/initiatives at a time.
- Ability to communicate effectively, both orally and in writing.
- Ability to foster a cooperative work environment.
- Knowledge of claims review and analysis.
Required Experience
EDUCATION REQUIREMENTS
- High school diploma or equivalent is required.
- Associate’s or bachelor’s degree in healthcare, business, or related area is preferred.
REQUIRED EXPERIENCE
- A qualified candidate should have a minimum of 3 years of relevant experience in medical collections or medical billing.