Tilte: Postbill Specialist

Department: Revenue Cycle Management

Reports To: VP of RCM

Position Summary:

The Postbill Specialist is responsible for timely follow-up on insurance claims after the initial sent claim to promptly facilitate payment from the appropriate source. Duties for this position are outlined below. The Postbill representative should be knowledgeable in the life cycle of a claim and the expectations of various payors.

Essential Functions:

The Postbill Specialist must adequately perform essential duties organizationally and efficiently. These duties may include, but are not limited to the following:

• Follow up on all assigned accounts from within the Billing systems in accordance with pre-established goals to ensure timely collections.
• Sorts and responds timely and accurately to all incoming insurance correspondence and inquiries.
• Responds to all phone calls from other departments or insurance companies efficiently and courteously.
• Prepares correspondence for the payer as necessary.
• Research calls/accounts and determines the nature of any problem with obtaining payment.
• Researches and analyzes accounts and payments; reverses balances to credit or debit if charges were improperly billed or if payments were incorrect.
• Ensures that all conditions for payment receipt have been satisfied, which includes, but is not limited to, accurate charges and payor category; authorization/certification information; claims address; ICD10 and HCPCS coding; patient insurance eligibility, patient benefit coverage; patient responsibility.
• Evaluate accounts to determine any write-offs or corrections required, including duplicate charges.
• Submits claims for secondary payment, as appropriate.
• Documents appropriate comments/notes in Billing System for every call, including any action taken.
• Thoroughly work on Aging reports as directed by management.
• Claim status by phone or online.
• Know when to file an appeal and ensure all appeals are timely.
• Recognize and post denials when needed.
• Research payor specific information, online, in provider manuals, and by calling payors.
• Other duties as assigned by Postbill Management.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below represent the knowledge, skills, and/or ability required. The individual in this position must possess the following qualifications:

• This position is based out of the Fort Lauderdale office.
• Must be proficient with Microsoft Suite (Excel, Word, PowerPoint).
• Excellent analytical skills and quality orientation-strives for continuous improvement in all activities to consistently achieve excellent results and meet or exceed department expectations.
• Must have knowledge of medical terminology.
• Must have willingness to work a flexible schedule.
• Overall leadership skills, including relationship building and fostering excellent achievement through teamwork.
• Must be self-starter with strong individual motivational skills.
• Strong interpersonal and communication skills with an ability to work effectively with a diverse range of individuals, from field teams to management, as well as external customers.
• Excellent ability to communicate and work cohesively across Department lines.
• Highly dependable and able to meet internal deadlines consistently.
• Flexible, adaptable, and able to adjust to rapidly changing priorities in a growing company.
• Must always maintain a professional demeanor and appearance.

Education Requirements:

The individual in this position must possess the following education requirements:

• Highschool diploma or GED

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The statements in this document are intended to describe the general nature and level of work performed by individuals assigned to the classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. This document in no way constitutes a contract of employment. Reva reserves the right to modify job descriptions, policies or any other procedural documents at any time, for any reason without prior notice.