RaleighRecruiter
the smart solution for Raleigh jobs

Healthcare Insurance Follow-Up Specialist

Company: The CSI Companies
Location: Raleigh
Posted on: May 19, 2019

Job Description:

CSI Professional is actively seeking a Healthcare Insurance Follow-Up Specialist?for a Contract position with our client located in the Raleigh, NC?area. This is an exciting opportunity to join our client?s,?a national medical group comprising providers of neonatal, anesthesia, maternal-fetal and pediatric physician sub-specialty services, team!? Schedule: Monday - Friday (normal business hours) Pay: Based on experience ***Prior Medical Collections experience?in a production-driven environment is fundamental for success in this role.*** Overview: The Healthcare Insurance Follow-Up Specialist?is responsible for effective and efficient accounts receivable management of assigned payors. The collections efforts on outstanding accounts includes: telephone contact with payers as well as patients, working high volume collection reports and correspondence, auditing accounts, appealing denied claims as necessary, updating accounts as needed, identifying carrier related denial trends and consistently meeting departmental productivity standards.? The incumbent performs required tasks on internal software as well as the Master Database, electronic claims vendors? software and various applications as well as using the internet to access payor websites. Extensive high volume collections experience with HMO?s, PPO?s, Workers Comp, Medicare and Medicaid. The successful individual must also be able to communicate and collaborate effectively with other internal as well as external resources in order to achieve desired results and resolve issues. Qualifications?

  • 3+ years collections exp in a high volume, healthcare / managed care, production-driven environment
    • Exp. w/ Denials/Appeals/Rejections/Aging
    • Exp. with Payer websites
    • Exp. w/ Managed Care Collection's
    • Exp w/ Medicare/VA
    • Associate's degree (A. A.) or equivalent from two-year college or technical school; or three to five years related experience and/or training; or equivalent combination of education and experience.
    • Understanding of medical terminology and protocols Responsibilities?
      • Ensures that claims are processed accurately through review and audit functions to ensure timely payment. Responds to inquiries regarding claims with under payment or non-payment. Responds to inquiries, questions, and concerns from patients regarding the status of claims in a clear, concise, and courteous manner. Interfaces with external and internal customers to ensure optimal efficiency of service.
      • Monitors aging of claims to ensure timely follow-up and payment.
      • Coordinates, monitors, and manages the follow-up on unpaid claims. Ensures follow-up and reimbursement appeals of unpaid and inappropriately paid claims. Ensures appropriate documentation of billing, follow-up, collection, and appeal efforts are recorded on accounts.
      • Identifies, researches, and ensures timely processing of billing errors and corrections as they relate to claims. Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties. Reviews error codes associated with claims to ensure correction, resubmission, and subsequent payment. Analyzes common errors to support quality assurance efforts. Ensures corrected claims are sent out and monitored for payment.
      • Maintains a working knowledge and understanding of CPT and ICD-10 codes. Keeps current with health care practices and laws and regulations related to claims collections through participation in professional development activities.
      • Prepares routine management reports, quality reports, and special reports as directed by supervisor. Communicates collection problems to supervisor and makes recommendations for changes.
      • Performs assignments accurately and on time, as directed. Assists other accounts receivable staff with workload and provides back-up support in their absence. Maintains individual productivity and performance standards.
      • Participates in administrative staff meetings and attends other meetings and seminars, as required. Assists in evaluation of reports, decisions, and departmental results in relation to established goals. Recommends new approaches, policies, and procedures to influence continuous improvements in department?s efficiency and services performed.
      • Serves as a member of the Accounts Receivable Department Team. Performs duties necessary to ensure the team?s projects/goals are completed. Takes ownership of special projects, researches data and follows through with detailed action plans.
      • Consistently adheres to company, Departmental, Operational, Office and HR policies and procedures. Reports to work, meetings and professional obligations on time.
      • Maintain strict confidentiality in accordance with HIPAA regulations and Company policy, including divulging any patient private health information (PHI) only on a need-to-know basis to payers requiring the information for claims payment processing.
      • Performs other duties as assigned or requested. For additional information, please apply!--

Keywords: The CSI Companies, Raleigh , Healthcare Insurance Follow-Up Specialist, Healthcare , Raleigh, North Carolina

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Occupational Therapist
Description: Occupational Therapist A great Skilled Nursing Facility SNF is looking for an experienced or newly graduated Occupational Therapist / OT to join their growing team for a 13 week assignment The Occupational (more...)
Company: Centra Healthcare
Location: Wilson
Posted on: 05/24/2019

Southern Virginia seeking Family Medicine Physician (Physician #40530)
Description: Hospital employed with 6 weeks PTO Loan Repayment up to 200,000 Office Based Join a hospital employed established
Company: National Health Partners
Location: Danville
Posted on: 05/24/2019

Physician: General Psychiatrist Position in Chapel Hill, North Carolina - JOB-2349507. - CompHealth
Description: A private practice in Chapel Hill, North Carolina is seeking a general psychiatrist to join their team. It is a full-time employed position, and you become a partner upon joining the practice. All psychiatry (more...)
Company: CompHealth
Location: Chapel Hill
Posted on: 05/24/2019


Speech-Language Pathologist
Description: A great Skilled Nursing Facility SNF is looking for an experienced Speech Language Pathologist / SLP to join their growing team for a 13 week contract Candidate must be an SLP-CCC. The Speech Language (more...)
Company: Centra Healthcare
Location: Wilson
Posted on: 05/24/2019

RN / REGISTERED NURSE / ER RN / EMERGENCY ROOM NURSE
Description: Job Reference Number: 19-938511 br br Our hospital in NC is looking for an ER RN for a 13 week travel contract. BLS, ACLS and NC or Compact Nursing
Company: Aureus Medical Group
Location: Wilson
Posted on: 05/24/2019

Emergency Medicine Physician (Physician #297127)
Description: Schumacher Clinical Partners is a privately held, physician-driven company dedicated to helping hospitals and providers focus on delivering high-quality patient care. As one of the nation's largest and (more...)
Company: Schumacher Clinical Partners
Location: Wilson
Posted on: 05/24/2019

Remote Health Insurance Agent - 100% commission, 3x daily payouts
Description: Remote Health Insurance Agent - 100 commission, 3x daily payouts Earn unlimited commission selling health insurance through ASSURANCE, and access our leading-edge insurance sales platform as an independent, (more...)
Company: Assurance
Location: Rocky Mount
Posted on: 05/24/2019

NE North Carolina CRNA job with $180Ks base - Plus Regionals + Student LOAN REPAYMENT
Description: Anesthesiology opening in Rocky Mount, North Carolina. This and other crna jobs brought to you by NursingJobCafe.com Please ask for Sean Goldstein at or when inquiring about this job. Come live and practice (more...)
Company: CompHealth
Location: Rocky Mount
Posted on: 05/24/2019

Pharmacy Technician- Target Store
Description: Job Description br Health is everything. At CVS Health, we are committed to
Company: CVS Health
Location: Chapel Hill
Posted on: 05/24/2019

Pediatric Private Duty RN LPN $2,000 Bonus
Description: Up to 2,000 Bonus br br Thrive Skilled Pediatric Care, one of the leading providers of skilled pediatric home care, is seeking nurses for clients in the Burlington area. Many locations and shift (more...)
Company: Thrive Skilled Pediatric Care
Location: Burlington
Posted on: 05/24/2019

Log In or Create An Account

Get the latest North Carolina jobs by following @recnetNC on Twitter!

Raleigh RSS job feeds