Insurance Follow Up Rep at CHI Health Clinic

Omaha, Nebraska, United States -

Full Time

Start Date

Immediate

Expiry Date

11 Sep, 26

Salary

24.35

Posted On

13 Jun, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Claim Resolution, Revenue Cycle Management, Billing Regulations, Problem Solving, Effective Communication, EOB Interpretation, Remittance Advice Analysis, Claims Resubmission, Account Receivable Management, Payer Negotiation

Industry

Hospitals and Health Care

Description

Where You’ll Work From primary to specialty care, as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours. Job Summary and Responsibilities As an Insurance Follow Up Rep, you will resolve unpaid insurance claims and collect outstanding balances from third-party payers.Every day you will review denials, initiate follow-up with insurers, rectify billing errors, submit appeals, and negotiate for maximum reimbursement.To be successful, you will understand billing regulations, possess strong problem-solving skills, and communicate effectively to optimize revenue recovery. Follows-up with insurance payers to research and resolve unpaid insurance accounts receivable; makes necessary corrections in the practice management system to ensure appropriate reimbursement is receive. Applies a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices, including when and how to ensure that correct and appropriate payment has been received. Communicates effectively over the phone and through written correspondence to explain why a balance is outstanding, denied and/or underpaid using accurate and supported reasoning based on EOBs, reimbursement, and payer specific requirements. Resubmits claims with necessary information when requested through paper or electronic methods. Anticipates potential areas of concern within the follow-up function; identify issues/trends and conducts staff training to address and rectify. Recognizes when additional assistance is needed to resolve insurance balances and escalates appropriately and timely through defined communication and escalation channels. Job Requirements Required None, upon hire Preferred High School GED General Studies and Two years of revenue cycle or related work experience , upon hire or High School Graduate General Studies and Two years of revenue cycle or related work experience , upon hire and Graduation from a post-high school program in medical billing or other business related field is , upon hire

Responsibilities

The role involves resolving unpaid insurance claims and collecting outstanding balances from third-party payers. Responsibilities include reviewing denials, submitting appeals, and rectifying billing errors to optimize revenue recovery.