Claims Follow Up Rep
lifespanGalway (NY)
$19.97-$32.96
ApplyAbout the role
SUMMARY:
Under general supervision of the Follow-up Supervisor, performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician multi-specialty practice. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:
Instill Trust and Value Differences
Patient and Community Focus and Collaborate
RESPONSIBILITIES:
Review all denied claims, correct them in the system and send correctedppealed claims as
written correspondence, fax or via electronic submission.
Identify and analyze denials and enact corrective measures as needed to effectively
communicate and resolve payer errors.
Continually maintain knowledge of payer specific updates via payer's listservs, provider
updates, webinars, meetings and websites.
Understand and maintain compliance with HIPAA guidelines when handling patient information
Contact internal departments to acquire missing or erroneous information on a claim
resulting in adjudication delays or denials.
Report to supervisor identification of denial trends resulting in revenue delays.
Answers telephone inquiries from 3rd party payers; refer all unusual requests to
supervisor.
Retrieve appropriate medical records documentation based on third party requests.
Refer all accounts to supervisor for additional review if the account cannot be resolved
according to normal procedures.
Work with management to improve processes, increase accuracy, create efficiencies and
achieve the overall goals of the department.
Maintain quality assurance, safety, environmental and infection control in accordance
with established policies, procedures, and objectives of the system and
affiliates.
Perform other related duties as required.
MINIMUM QUALIFICATIONS
BASIC KNOWLEDGE: Equivalent to a high school graduate.
Knowledge of 3rd party billing to include ICD, CPT, HCPCS and 1500 claim forms.
Demonstrated skills in critical thinking, diplomacy and relationship-building.
Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings.
Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies.
EXPERIENCE: One to three years of relevant experience in professional billing preferred.
Experience with Epic a plus.
INDEPENDENT ACTION:
Incumbent generally establishes own work plan based on pre-determined priorities and standard procedures to ensure timely completion of assigned work. Problems needing clarification are reviewed with supervisor prior to taking action.
SUPERVISORY RESPONSIBILITY: None
Pay Range
$19.97-$32.96
EEO Statement:
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.
Location
Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903
Work Type
Mon-Fri 7:30-4
Work Shift
Day
Daily Hours
8 hours
Driving Required
No
Before you apply
Applying takes about a minute. These four things decide how fast it moves after that.
Your profile is current
It's what we read first. Occupations, seniority and locations matter more than a long history.
Two examples you can talk through
Not a portfolio — just two pieces of work where you can explain the decisions and what you'd change.
A number in mind
What you're on now and what would make you move. We negotiate better when we know both.
Your notice period
Employers plan around it, and it's the question that stalls offers most often.
Once you apply, someone reads it and calls you before anything reaches the employer — usually within two working days.
More like this