Billing and Insurance Follow-Up Specialist

Position Location: Ramsey, New Jersey

Position Reports to: Manager – Revenue Cycle Management

Job Summary:

Responsible for ensuring claims are accurately submitted, resolving discrepancies and following up with insurance companies and patients to ensure timely payment of medical claims.

Duties/Responsibilities:

• Navigate claim submission and payee websites/portals to resolve filing issues and research status of payments.
• Speak with insurance companies to research denials and/or improper reimbursement.
• Apply payer requirements for submission of reconsiderations, appeals, medical records, etc.
• Communicate with patients and clients to facilitate claim adjudication and payment.
• Maintain knowledge of coverage policies and medical necessity requirements of insurance carriers.
• Research and resolve billing issues raised by patients.
• Prepare, review and send patient statements.
• Process patient credit card payments.
• Perform patient collection actions via email, mail, and phone in adherence to legal and regulatory requirements.
• Process financial assistance applications.
• Establish installment agreements within the billing system.
• Troubleshoot and resolve issues within the billing applications.
• Monitor and report status of delinquent accounts.
• Work closely with co-workers and management to analyze data and identify issues or trends.
• Prepare cases to be sent for outside collections efforts.
• Conduct business in a responsible manner that complies with all state and federal regulations applicable to laboratory services and medical billing.
• Other duties as assigned.

Required Skills/Abilities:

• · Knowledge of payer applications (e.g., CMS and commercial payers)
• · Knowledge of CMS and commercial payer coverage policies
• · Knowledge of Microsoft Office Suite
• · Excellent written and verbal communication skills.
• · Excellent organizational and time management skills.

Education and Experience:

• · High school diploma or equivalent required.
• · 3 years or more in a similar role required
• · Laboratory experience preferred
• · Laboratory billing experience preferred; knowledge of TELCOR a plus
• · TELCOR experience preferred