·         Timely follow-up on hospital patient accounts that are outstanding for insurance payment, including but not limited to the following processes: verify claim payment status, rebill to patient’s insurance, proration to correct financial class and notation within patient accounts providing steps taken to resolve outstanding insurance balance on account.

·         Work an average of 30-40 patient accounts per workday for assigned payor(s)

·         Manages an average of 30-40 patient accounts per day, focusing on denial and zero-pay reporting.

·         Assigned Payor denials and Zero ($0) pay reports worked within 48 hours of receipt

·         Communicate effectively with insurance companies for payment of outstanding insurance balances, understanding of next steps needed to reach resolution of outstanding insurance balance

·         Perform research on patient accounts with outstanding insurance balances and route patient accounts through appropriate workflows

·         Responsible for resolving patient accounts with outstanding insurance claims to a zero balance or advancing them to the patient responsibility financial class.

·         Performs account follow-up on unpaid or partially paid insurance claims for hospital services.

·         Contacts insurance payors through various methods, including telephone calls, Insurance payor web portals, E-faxing, email

·         Investigates the cause of non-payment towards outstanding hospital claims and takes appropriate actions such as: Requesting insurance companies to process claims, requesting cash posting review for corrections, initiating coding reviews for account resolution, contacting patient for insurance information

·         Completes adjustment requests for Team Lead approval if an adjustment to the outstanding balance 

·         Submits requests for claim rebilling when additional information is required, using either a shared spreadsheet or the EHR system. Utilizes MEDTEAM’s ticketing system to submit claim inquiry requests if additional information or review from the hospital is required.