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Insurance Billing/Follow Up Specialist II

Company: Vail Health Technician Healthsource
Location: Vail
Posted on: January 9, 2022

Job Description:

POSITION PURPOSE: Prepares and submits claims. (Institutional and Professional). Proficient at management of assigned inventory with the ability to work in an alternate inventory as required for coverage.ORFollows-up on insurance claims within required timeframes as identified in the Essential Job Functions. ESSENTIAL JOB FUNCTIONS: 1. Accurately prepare and submit claims in the work queue within the required time frame afternoon billing information is available, following all organization, payer and regulatory guidelines. (Institutional and Professional). Proficient at management of assigned inventory (multiple service lines). 2. Follow-up on insurance claims within 30 days of billing for commercial payers and 21 days of billing for government payers. Maintain ATB for assigned accounts > 90 days from discharge at Monitor KPI's and report weekly/monthly as required. Obtain additional information from patient/guarantor as needed for claims processing. 3. Submit claims edits to CDM specialist or HIM coder queue as appropriate based on code origination. 4. Respond to Customer Service inquiries within 48 hours of request. 5. Review and process assigned correspondence daily. Process denials and appeals at a minimum weekly. 6. Expedite resolution for denial and rejected claims, referring these to the immediate supervisor when > 3 attempts are made without claims adjudication 7. Obtain additional information from patient/guarantor as needed for claims processing. 8. Contribute to department process improvement activities 9. Model the principles of "Just Culture". 10. Performs other duties as assigned. Compliant with HIPAA, The Joint Commission and other regulatory agencies as required. MINIMUM QUALIFICATIONS: Experience: Two years healthcare financial experience required. Prior Hospital or physician billing experience strongly preferred. License(s): N/A Certification(s): Certified Patient Financial Services Certification (HBI) or comparable years of experience (> 2years) preferred. Certificate in healthcare billing and coding preferred. Computer / Typing: Must possess, or be able to obtain within 90 days, the computers skills necessary to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc. Must have working knowledge of the English language, including reading, writing, and speaking English.

Keywords: Vail Health Technician Healthsource, Vail , Insurance Billing/Follow Up Specialist II, Other , Vail, Colorado

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