[Remote] PFS CBO Rep Insurance Follow-Up Ambulatory Denials

Note: The job is a remote job and is open to candidates in USA. reputed company is a nationally-recognized healthcare leader that offers rewarding careers in various disciplines. The PFS Insurance Follow-Up Representative is responsible for following up with payers for various denials and ensuring timely reimbursement for services. This role involves coordination of billing and collection activities, as well as providing excellent customer service to patients and internal clients.

Responsibilities

• May be assigned to process payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment plans in an accurate and timely manner, meeting goals in work quality and productivity. Coordinates with other staff members and physician office staff as necessary ensure correct processing
• As assigned, reconciles, balances and pursues account balances and payments, and/or denials, working with payor remits, facility reputed company, payor customer service, provider representatives, spreadsheets and the company’s collection/self-pay policies to ensure maximum reimbursement
• May be assigned to research payments, denials and/or accounts to determine short/over payments, contract discrepancies, incorrect financial classes, internal/external errors. Makes appeals and corrections as necessary
• Builds strong working relationships with assigned business units, hospital departments or provider offices. Identifies trends in payment issues and communicates with internal and external customers as appropriate to educate and correct problems. Provides assistance and excellent customer service to these internal clients
• Responds to incoming calls and makes outbound calls as required to resolve billing, payment and accounting issues. Provides assistance and excellent customer service to patients, patient families, providers, and other internal and external customers
• Works as a member of the patient financial services team to reputed company goals in days and dollars of outstanding accounts. Reduces Accounts Receivable balances
• Uses systems to document and to provide statistical data, prepare issues list(s) and to communicate with payors accurately
• Works independently under general supervision, following defined standards and procedures. Reports to a Supervisor or Manger. Uses critical thinking skills to solve problems and reconcile accounts in a timely manner. External customers include reputed company hospital patients, patient families and reputed company third party payers. Internal customers include facility medical records and patient financial services staff, attorneys, and central services staff members

Skills

• Minimum of 1 year experience in Medical Insurance AR and/or Physician Fee for Service Billing clearly reflected in uploaded resume
• Minimum of 1 year experience writing appeal letters for payer denials
• Intermediate to Advanced reputed company level in reputed company reputed company
• High school diploma/GED or equivalent working knowledge
• Requires knowledge of patient financial services, financial, collecting services or insurance industry experience processes normally acquired over one or more years of work experience
• Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently
• Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences
• Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required
• Work experience with the Company's systems and processes is preferred
• Previous cash collections experience is preferred
• Additional reputed company Education And/or Experience Preferred

Company Overview

Company H1B Sponsorship