White Plains Hospital Job Description

Title: Insurance Follow-Up Representative

Job Code: 800540

Department/Location: Patient Accounts

FLSA Status: Non-exempt

Reports to: Supervisor, Patient Accounts

Position Summary

Responsible for initiating follow-up to third party payers on delinquent accounts and reviewing insurance
correspondence and responding in a timely manner. Responsible for supplying third party payers with appropriate
billing information in order to adjudicate a claim. Responsible for assuring appropriate payment received in
accordance with contract terms Performs other duties as assigned
Essential Functions and Responsibilities Includes the Following:
1. Understands and adheres to the WPH Performance Standards, Policies and Behaviors
2. Completes review of third-party outstanding balances and takes appropriate steps to resolve and
reconcile outstanding balances
3. Reviews correspondence for appropriate action to resolve accounts
4. Researches and initiates refunds to patients or insurance carries as needed
5. Sends inquiries to patients regarding inaccurate or incomplete information
6. Completes charge adjustments and allowances entries on accounts as needed
7. Recodes accounts by insurance carrier and plan number and enters into the health information system (HIS) for
re-billing purposes
8. Processes rejections on third party accounts
9. Reviews on-line billing edits for errors, corrections, or missing information. Enter necessary corrections into HIS
10. Assists with telephone calls as needed
11. Works with vendors as necessary to reconcile and resolve outstanding accounts
12. Assures payers process claims timely and according to contract provisions.
13. Performs all other related duties as assigned
14. HBI certification certificate required prior to end of probationary period

Education & Experience Requirements
ï‚· High School Graduate or GED required
ï‚· Clerical experience preferred
ï‚· Hospital business office experience preferred
ï‚· Medical terminology required
ï‚· Ability to use basic office equipment and Knowledge of CTR computer terminals a plus

Core Competencies
ï‚· Teamwork, Communication skills, problem solving, adaptability
ï‚· Must be able to speak, write understand and communicate the English language
ï‚· Effectively communicate with internal and external customers
ï‚· Retains composure under stress
ï‚· Integrity to handle the confidential aspects of work