Fully Remote Position

Position Summary:
Responsible for the maximization of reimbursement by contacting insurance carriers and/or 3rd parties daily to collect outstanding insurance balances due, resolve disputes and denials and general non-payment issues.

Responsibilities:

• Perform client account follow up daily in accordance with TEP policies and procedures.
• Understanding of and adherence to payer policies and protocol. Utilize Payer resources to resolve disputes and denials.
• Adhere to payer timely filing limits and work accounts to resolve within payer timely filing parameters. Appeal claims when appropriate and within timely filing limits.
• Accept incoming calls from patients, insurance carriers and other 3rd parties to resolve issues and maximize reimbursement.
• Perform due diligence in reconciling outstanding balances ensuring all efforts have been exhausted in resolving issues with payers prior to write-off.
• Reconcile account payments (insurance carrier, patient and/or 3rd party) to ensure full and accurate reimbursement is received and/or correct balance is due.
• Research all payer refund requests, recoupments and credit balances for accuracy and appeal if appropriate.
• Re-file claims when necessary and appropriate only after payer contact.
• Familiar with Payer contracts to ensure compliance.
• Identify non-payment trends for payers and work with manager to resolve.
• Keep manager apprised of any issues and concerns preventing and/or disrupting daily workflow.

Qualifications:

• Minimum of 3 years’ Billing and Accounts Receivable experience in healthcare office environment.
• Coding experience a plus.
• Significant experience using Microsoft Office - Word, Excel, PowerPoint, Outlook.
• Ability to learn and adapt to internal software programs.