Insurance Follow Job Description

Insurance Follow Job Description

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Insurance follow provides extensive analysis and trending responsible for improving all billing functions and follow-up for hospital claims.

Insurance Follow Duties & Responsibilities

To write an effective insurance follow job description, begin by listing detailed duties, responsibilities and expectations. We have included insurance follow job description templates that you can modify and use.

Sample responsibilities for this position include:

Supervises and evaluates the daily operations of assigned support functions (including claims processing, clinic customer service, charge capture/cash posting, refunds/credits, insurance follow-up, ) to ensure that all activities are conducted in a timely and cost-effective manner and in accordance with professional standards, budget constraints, internal policies/standards/procedures and/or applicable legal/regulatory requirements
Meets departmental productivity and quality assurance standards in accordance with departmental policies
Schedules, supervises and evaluates the work of assigned revenue cycle staff in accordance with established standards and procedures
Monitors compliance with applicable internal/external legal and regulatory agreements, standards and requirements
The Lead Ins
Under general supervision of the PFS Follow-Up Supervisor, is responsible for following up Managed Care and Commercial insurance products
Resolves and resubmits rejected claims appropriately as necessary
Processes daily and special reports, error logs, stalled reports and aging
May perform outgoing calls to Patients and Insurance companies to obtain necessary information for accurate billing
May answer incoming calls from Insurance companies requesting additional information and/or checking status of billings

Insurance Follow Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Insurance Follow

List any licenses or certifications required by the position: EPIC

Education for Insurance Follow

Typically a job would require a certain level of education.

Employers hiring for the insurance follow job most commonly would prefer for their future employee to have a relevant degree such as Associate and High School Degree in Business/Administration, Business, Finance, Associates, Health Care, Business/Management, Education, Accounting, Health Care Administration, Computer

Skills for Insurance Follow

Desired skills for insurance follow include:

Hospital business office functions
Standards
Billing software
Blue Cross Blue Shield
Care management organizations
Clearinghouse
Commercial payors
Comparable system
Dentrix Dental
Health maintenance organizations

Desired experience for insurance follow includes:

Responsible for providing support and service to all AHS Facilities in the East Florida Regional Market
Proficiency typically reached via on the job training and orientation after one year
Submit written documentation, remittance advice and/or re-file claim(s) denials to various carriers
Communicate with patients, staff members of practices, and insurance carriers through their Websites and/or direct telephone contact to resolve claim issues
Perform appropriate billing functions, including manual re-bills electronic submission to payers
Submit patient claims, paper and electronic, after corrections have been made or when re-billing is needed

Insurance Follow Examples

1

Insurance Follow Job Description

Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of insurance follow. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for insurance follow
  • Analyzes related AR activity and develops or refines internal processes to consistently reach and maintain established AR goals
  • Develops plan of action and implements process refinements to address and manage health plan problems and/or changes
  • Monitors insurance follow-up activities from initial health plan denial through claim resolution
  • Responsible for setting goals and the development of staff
  • Proactively reviews established processes to ensure maximum collection opportunities
  • Identifies root causes for identified problems and makes necessary changes to improve outcomes
  • Takes an active role in developing supporting software and processes
  • Submits personal performance goals to manager on a yearly basis
  • Assess staff workload and guides staff in setting priorities
  • Develops and documents procedures based on Patient Accounts policy
Qualifications for insurance follow
  • High School Diploma or GED completion
  • Reviews and is knowledgeable about all Patient Accounts procedures
  • Displays awareness of needs of other areas
  • Schedules and prioritizes for self and others
  • Demonstrates the skills necessary for effective delegation and empowerment
  • Contact insurance payers regarding unpaid hospital claims
2

Insurance Follow Job Description

Job Description Example
Our growing company is looking to fill the role of insurance follow. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for insurance follow
  • Write and submit appeals
  • Answer phone inquiries from patients and insurance regarding bills, charges, and account status
  • Resolve issues holding up timely claim payment, including requests for medical records, coordination with Customer Service and other related departments
  • Investigates over-payments and takes appropriate action to resolve
  • Follows up on payer payment variances
  • Direct day-to-day operations, priorities and broad scope work assignments for the A/R follow-up team
  • Develop and monitor reporting tools to track Key Performance Indicators (KPIs), (e.g.Queue Status, Daily Cash Collections and Write-offs, Claims Filed, etc)
  • Develop goals and objectives and measures performance on a macro basis on a regular basis
  • Make recommendations and implement continual process improvements to improve cash yield and timely collection
  • Review carrier websites and publications for updates regarding billing procedures and requirements
Qualifications for insurance follow
  • Bachelor's degree or equivalent work experience (five years in healthcare billing environment)
  • Experience with EPIC Billing system preferred
  • Epic Billing certification preferred
  • Review data, reports, and statistical information, analyze trends, and render adjustments to team priorities and operations, to increase effectiveness
  • Represent the RCM team and/or assigned department on committees, work groups, or task forces and attend pertinent functions, as requested
  • Promote by personal example, a positive “esprit de corps”
3

Insurance Follow Job Description

Job Description Example
Our innovative and growing company is hiring for an insurance follow. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for insurance follow
  • Develop and sustain excellent working relationships with AMR professionals (e.g., Operations, Business Development, IT, and Finance), with the Company’s clients, payors, consultants, banks and financial intermediaries, and government agencies
  • Work well with other leaders to communicate and share resources on critical projects
  • Demonstrate creativity and initiative in maximizing the efficient use of staff resources
  • Audit Aged Trial Balance Reports
  • Ability to stay work focused and perform job duties efficiently and accurately
  • Work within company attendance guidelines
  • Contacts guarantors and HMO insurance companies by telephone in an effort to resolve hospital accounts
  • Diagnoses and initiates research necessary to resolve customer issues in a timely manner
  • Completes forms including fax cover sheets, linking and unlinking slips
  • Reviews correspondence including, but not limited to, dispute letters, EOBs, remittances, and cancelled checks
Qualifications for insurance follow
  • Inputs data into computer
  • Practices and adheres to the Parallon “Code of Conduct” philosophy and “Mission and Values Statement”
  • May include use of insurance websites
  • Follows up and Reports Trends on payer payment variances
  • Identify denials and submit appeals in a timely manner
  • Minimum of 3-year experience in hospital business office
4

Insurance Follow Job Description

Job Description Example
Our growing company is searching for experienced candidates for the position of insurance follow. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for insurance follow
  • Documents all activities and findings in accordance with established policies and procedures
  • Assigns and reviews work to facilitate smooth workflow
  • Monitors and assesses current operations/services to identify performance/process improvement opportunities
  • Establishes and maintains professional and effective relationships with peers, payers, patients and other stakeholders
  • Responsible for daily follow up on primary insurance by assigned alphabet/facility
  • Responsible to work zero-pay claims with additional information requests
  • One years' minimum experience required
  • Follow-up with insurance companies on billed claims regarding claim status and resolution of payments in a timely manner
  • Work high dollar insurance pools and contact insurance companies to resolve claims that are not paid in a timely manner
  • Work with patients and guarantors to resolve payer requests and discrepancies to promptly resolve pending claims
Qualifications for insurance follow
  • Must be competent in medical billing of all Commercial, Government and Managed Care Payers
  • Minimum 3 year experience in Hospital Business Office conducting Accounts receivable Follow up
  • Must have three years of experience in a hospital business office, physician business office, or insurance company, to include two years of experience in medical billing and/or collecting from third party payors
  • May have an equivalent combination of education and/or experience in lieu of specific experience as stated above
  • Must be able to exercise good judgment in handling government and/or non-government accounts and understand managed care and insurance contractual arrangements
  • Must have working knowledge of medical software
5

Insurance Follow Job Description

Job Description Example
Our growing company is hiring for an insurance follow. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for insurance follow
  • Prepares and maintains resource materials to support, participate and lead training exercises and classes
  • Completes QA analysis of all critical follow up and denial elements using QA audit tools to correctly identify users
  • Performs routine system and process testing as requested by the Administrator
  • Prepares monthly QA evaluation reports and submits detail and summary reporting to appropriate leadership
  • Identifies, recommends, documents and tracks resolution to process gaps and best practice to leadership for ongoing process improvements needed in the department
  • Maintains QA electronic files, adding and deleting users, distribution lists and folders as needed
  • Develops departmental SOP’s as needed
  • Computes and reports statistical QA data in a variety of formats, without computational errors, spotting trends and/or patterns
  • Provides backend follow up support as needed
  • Consults with manager on better operational procedures to improve overall efficiency and quality yields
Qualifications for insurance follow
  • Must be able to handle potentially stressful situations and multiple tasks simultaneously including discussing outstanding claims with the insurance company, taking action on denied claims, and processing appeals
  • Must be able to solve problems within the guidelines of established policies and procedures
  • Three years of revenue cycle or related work experience that demonstrates attainment of the requisite job knowledge and abilities
  • Minimum of three years experience in a hospital or physician office setting specifically in the area of billing
  • Minimum five years' experience in hospital accounts receivable experience
  • Minimum three years' of progressive supervisory / management experience

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