General Summary: Performs account follow up and resolution of Insurance claims. Contact insurance payors on aged and or delayed claims for resolution. Ability to research accounts to complete appropriate follow-up actions that result in an account payment and resolution. Monitor insurance claims for payment to resolve if not paid in a timely manner. Identify problem accounts and escalate as appropriate. Requires critical thinking skills, problem-solving, decisive judgment, ability to work with minimal supervision and must possess excellent time management and organizational skills. Must be able to work in a stressful environment and take appropriate action.
Essential Duties:
Performs account follow up and resolution of Insurance claims. Contact insurance payors via telephone on aged and or delayed claims for resolution.
Ability to research accounts to complete appropriate follow up actions that result in an account payment and resolution. Working knowledge of all facets of insurance claim filing, requirements and regulations.
Monitor insurance claims for payment to resolve if not paid in a timely manner.
Identify problem accounts and escalate as appropriate. Update patient accounts records to reflect action taken. Work with insurance and patients to secure timely payment on outstanding account balances.
Maintain a professional image and provide excellent customer service.
Attend department meetings and education sessions. Meet/exceed performance expectations within required timeframes.
Practice and adhere to the "Code of Conduct" philosophy and Mission and Values statement.
Supports special projects as requested. Adheres to all Beaumont Health Business Service Policies and Procedures.
Payer training for new hires on Epic, Workqueue's, payer process, websites and procedures.
Performs other duties as assigned.
Standard Qualifications
High school diploma or GED.
Minimum of one-year collection experience. Relevant education may substitute experience requirement.
Billing experience, knowledge of UB claims form and knowledge of insurance payment methodologies or knowledge of revenue cycle.
Must be proficient with Excel, Microsoft Word, and PowerPoint.
Beaumont Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity, sexual orientation, age, status as a protected veteran, or status as a qualified individual with a disability.