As a Patient Accounts Representative Follow-Up Specialist, you :

• Are responsible for daily follow-up functions to secure payment and / or resolve outstanding accounts receivable for one or more of the assigned payer categories : Medicare, Medicaid, Blue Cross and Blue Shield, Commercial / Managed Care, Tri-Care, Worker's Compensation, Schools, DSS / DJS, and Self-Pay.
• Use computerized patient management and electronic imaging systems to initiate and update patient accounts with data required for preparation of third-party claims and client statements, and adjust third-party / self-pay data.
• Prepare and maintain required documentation.
• Analyze, review and interpret third-party benefit claims, charges, payments and Financial Assistance documentation; debit and credit patient accounts;

determine proper percentages for proration and perform calculations to properly calculate discounts for third party and patient bills.

The vast majority of this position involves interaction with insurance companies with only a very small percentage involving interaction with clinicians and patients.

Requires :

• High School diploma
• 6 months of experience in related billing and health insurance work. Follow-up and Medicaid experience strongly preferred.
• Must have knowledge of billing practices, procedures, collections, third-party payer and Universal Billing requirements, and third-party reimbursement procedures.

Last updated : 2024-02-26