The Third Party Follow-up Rep performs follow-up procedures on unpaid third party accounts. Responsibilities
1. Performs account analysis to ascertain the required follow-up procedure.
2. Researches suspended/pending claims and transfers information to the payer.
3. Prepares report for payer for large volume of outstanding claims.
4. Reports collection efforts/issues for high dollar accounts to management at monthly meetings
5. Processes third party vouchers and verifies accuracy and timeliness of payment.
6. Reconciles managed care payments to the explanation of benefits to determine patients's responsibility and performs comparison to managed care contract for accuracy.
7. Initiates aging reports by financial class in order to identify problematic areas and accelerate cash flow.
8. Resubmits claims to payers via hard copy, fax, or electronic medium.
9. Contacts physician offices and/or patient and other hospital departments to secure the appropriate information (referrals, notifications, pre-authorizations, and any other required documentation for the payer) in order to process the claim.
10. Adheres to the standards identified in the Medical Centers Organizational Competencies. Qualifications
Education, Knowledge, Skills and Abilities Required:
- High school diploma or equivalent.
- Knowledge of Managed Care, Medicare, and Medicaid payers
- Hospital billing and contract management knowledge is preferred
- Denials and underpayment experience is preferred
As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.
Posting ID: 552622676Posted: 2020-05-27