Rogers Behavioral Health
Insurance Follow Up Specialist 1
Rogers Behavioral Health, Oconomowoc, Wisconsin, United States, 53066
The Insurance Follow-up Specialist Level I is responsible for following up directly with commercial and governmental payers to resolve billing issues and secure appropriate reimbursement in a timely manner, on both facility and professional claims. This individual identifies and analyzes denials and payment variances and enacts corrective measures as needed to effectively communicate and resolve payer errors.
Representatives' work in a queue-based environment and are expected to follow-up on an average of 60-70 accounts per day, ensuring all organizational objectives for the A/R performance are met or exceeded. This is a high performing department that requires strong problem-solving skills and the ability to learn new concepts quickly.
Schedule: Monday-Friday 8a-4:30pmFollow up and investigate any denied, unpaid, or underpaid claims to determine reasons for
discrepancies.Collaborate with respective team members/supervisors for resolution.Manage and maintain outstanding account balances to ensure accurate reporting of Accounts Receivable.Meet position's goals and objectives related to accuracy and productivity, i.e., days in Accounts Receivable, cash collections open claim count, reimbursement metrics, etc.Utilizes payer scorecards, identify high-risk accounts, and prioritizes follow-up efforts.
Work to ensure timely receipt and appropriate reimbursement.Work various systems and reports to ensure accurate classification of accounts and to ensure that all accounts have been billed and received by payers.Suggest billing component changes as necessary for payers.
Communicates directly with payers to follow up on outstanding claims, resolve payment variances, and achieve timely
reimbursement.Address issues and clear barriers to payment.Utilize on-line/telephonic resources to verify benefits and to ensure claims are processed according to the appropriate benefit levels.Participates in continuous quality improvement efforts on an ongoing basis, establishing goals with supervisors and tracking progress.
Responsible for managing claim details and verifying accurate reimbursement.Initiate account adjustments and/or appeals on payment disputes.File appeals for denied claims and follow up as necessary through appeal resolution.Submit refund requests as necessary.Additional Job Description:Education/Training Requirements:Two years of business office experience in billing, customer service or collections is required. High school diploma or equivalent requiredMin of 1 year of relevant insurance experience in mental health or medical account resolution, collections or professional billing strongly preferred.Knowledge of claims review and analysis, along with a full understanding of healthcare explanation of benefits (EOB)Knowledge of all payer's insurance, self-pay after insurance, reimbursements, collections, appeals, claims follow- up.Experience with Cerner Revenue Cycle preferred.
Valid driver license. Must be granted insurable status by the Rogers Memorial Hospital insurance policy.With a career at Rogers, you can look forward to a Total Rewards package of benefits, including:Health, dental, and vision insurance coverage for you and your family401(k) retirement planEmployee share programLife/disability insuranceFlex spending accountsTuition reimbursementHealth and wellness programEmployee assistance program (EAP)Through UnitedHealthcare, UMR and HealthSCOPE Benefits creates and publishes the Machine-Readable Files on behalf of Rogers Behavioral Health.
To link to the Machine-Readable Files, please visit
Transparency in Coverage (uhc.com)
Representatives' work in a queue-based environment and are expected to follow-up on an average of 60-70 accounts per day, ensuring all organizational objectives for the A/R performance are met or exceeded. This is a high performing department that requires strong problem-solving skills and the ability to learn new concepts quickly.
Schedule: Monday-Friday 8a-4:30pmFollow up and investigate any denied, unpaid, or underpaid claims to determine reasons for
discrepancies.Collaborate with respective team members/supervisors for resolution.Manage and maintain outstanding account balances to ensure accurate reporting of Accounts Receivable.Meet position's goals and objectives related to accuracy and productivity, i.e., days in Accounts Receivable, cash collections open claim count, reimbursement metrics, etc.Utilizes payer scorecards, identify high-risk accounts, and prioritizes follow-up efforts.
Work to ensure timely receipt and appropriate reimbursement.Work various systems and reports to ensure accurate classification of accounts and to ensure that all accounts have been billed and received by payers.Suggest billing component changes as necessary for payers.
Communicates directly with payers to follow up on outstanding claims, resolve payment variances, and achieve timely
reimbursement.Address issues and clear barriers to payment.Utilize on-line/telephonic resources to verify benefits and to ensure claims are processed according to the appropriate benefit levels.Participates in continuous quality improvement efforts on an ongoing basis, establishing goals with supervisors and tracking progress.
Responsible for managing claim details and verifying accurate reimbursement.Initiate account adjustments and/or appeals on payment disputes.File appeals for denied claims and follow up as necessary through appeal resolution.Submit refund requests as necessary.Additional Job Description:Education/Training Requirements:Two years of business office experience in billing, customer service or collections is required. High school diploma or equivalent requiredMin of 1 year of relevant insurance experience in mental health or medical account resolution, collections or professional billing strongly preferred.Knowledge of claims review and analysis, along with a full understanding of healthcare explanation of benefits (EOB)Knowledge of all payer's insurance, self-pay after insurance, reimbursements, collections, appeals, claims follow- up.Experience with Cerner Revenue Cycle preferred.
Valid driver license. Must be granted insurable status by the Rogers Memorial Hospital insurance policy.With a career at Rogers, you can look forward to a Total Rewards package of benefits, including:Health, dental, and vision insurance coverage for you and your family401(k) retirement planEmployee share programLife/disability insuranceFlex spending accountsTuition reimbursementHealth and wellness programEmployee assistance program (EAP)Through UnitedHealthcare, UMR and HealthSCOPE Benefits creates and publishes the Machine-Readable Files on behalf of Rogers Behavioral Health.
To link to the Machine-Readable Files, please visit
Transparency in Coverage (uhc.com)