Insurance Follow Up Representative

About the Role

Key Responsibilities

• Perform timely follow-up on accounts to ensure prompt payment.
• Maintain daily queue in current status per ASD guidelines.
• Identify and correct coding or billing issues from EOBs promptly.
• Monitor insurance claims and resolve unpaid claims with insurance companies.
• Prepare accounts for rebilling and filing secondary insurance with necessary documents.
• Handle denials with coder and physicians to secure reimbursement.
• Address patient and insurance inquiries effectively.
• Update patient account records with actions taken.
• Assign bad debt accounts to collection agencies as approved.
• Act as a liaison for third-party account collections as per Center practices.
• Reconcile accounts transferred to outside agencies.
• Administer Center contracts with third-party payers following facility guidelines.
• Notify management of contractual issues inconsistent with contract language.
• Negotiate payment plans for self-pay accounts under established policies.
• Submit weekly collections reporting as per facility practices.
• Achieve and maintain accounts receivable days at the ASD goal.
• Reduce and maintain bad debt at the ASD goal.
• Review and turn over aged accounts to outside collection agencies regularly.
• Follow best practices for initial and subsequent insurance claim follow-ups.
• Provide business office and admissions backup as needed.
• Participate in meetings and committees as requested.
• Perform cross-training and other duties as assigned based on business needs.

Requirements

• Experience with MediCal and major payer portals, including Advantx, Availity, and Waystar, is a plus.
• Ability to manage multiple tasks and priorities effectively.
• Strong communication and negotiation skills.
• Ability to work independently and remotely.

Nice to Have

• Experience with Advantx, Availity, Waystar, and major payer portals.