UnityPoint Health

  • Third Party Billing and Follow-Up Representative II

    Requisition ID
    2018-51372
    Category
    Billing and Coding
    Location
    US-WI-Madison
    Address
    301 S Westfield Rd
    Affiliate
    9010 Administration
    City
    Madison
    Department
    CBO- Madison
    State
    WI
    FTE
    1.0
    FLSA
    Non-Exempt
    Scheduled Hours/Shift
    7:00am -3:30pm; Monday - Friday
    Work Type (Portal Searching)
    Full Time Benefits
  • Overview

    Billing and Follow-Up representatives   will be responsible for performing all billing and follow-up functions, including the investigation of payment delays, resulting from no response, denied, rejected and/or pending claims with the objective of appropriately maximizing reimbursements and ensuring that claims are paid in a timely manner. This position requires strong decision making ability around complex claims processing workflows and regulations that requires utilization of data coming from multiple resources. To evaluate billing and follow-up issues appropriately, Reps will need to have an understanding of the entire Revenue Cycle and be able to interact with Government and Commercial insurances.

    Responsibilities

    Billing and Follow Up Responsibilities

    • Resolve billing errors/edits, including accounts with Stop Bills and “DNBs” to ensure all claims are filed in a timely manner
    • Ensure all claims are accurately transmitted daily and all appropriate documentation is sent when required
    • Verify eligibility and claims status on unpaid claims
    • Review payment denials and discrepancies and take appropriate action to correct the accounts/claims.
    • Respond to customer service inquiries
    • Perform charge corrections when necessary to ensure services previously billed incorrectly are billed out correctly
    • Submit replacement, cancel and appeal claims to third party payers
    • Provide timely feedback to management of identified claims issues, repetitive errors, and payer trends to expedite claims adjudication.
    • Work accounts in assigned queues in accordance with departmental guidelines.
    • Contact patients for needed information so claims are processed /paid in a timely manner
    • Work directly with third party payers and internal/external customers toward effective claims resolution.

    Qualifications

    Education

    • High school graduate or GED equivalent

    Experience

    • Medical billing experience preferred

    Skills

    • Interpersonal skills
    • Written and verbal communication
    • Basic computer skills
    • Motivation
    • Teamwork
    • Customer/Patient focused
    • Professionalism
    • Planning and organizing skills
    • Technical aptitude- ability to learn new systems quickly.
    • Problem-solving
    • Microsoft Excel/Word/Outlook

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