Sonic Healthcare USA

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Insurance Follow-up

Insurance Follow-up

Job Location 
US-TX-Round Rock
Posted Date 
8/14/2017
Type 
Regular Full-Time
Shift 
Second shift

More information about this job

Overview

Responsible for the management of commercial insurance accounts through written direction from insurance carriers, resolve pending claims for accurate and timely resubmission for maximum reimbursement and posting rejections with accurate explanations, strong data entry skills a must.  Ability to provide support to other Accounts Receivable Departments, as needed.  Adhere to all department policies and procedures.

 

Respects and maintains the confidentiality of information relative to the laboratory.  Adheres to all accounts receivable policies, procedures and compliance guidelines.  Works with minimal direction, consults with Team-leader or Supervisor as needed.

Responsibilities

Principal Responsibilities:

 

  • Customer service duties include answering telephones politely and confidently for patients and others regarding billing inquiries and resolving billing issues when needed for coverage or backup.
  • Act as a resource to CPL personnel and clients regarding insurance guidelines.
  • Accurately enter information provided by various sources to correct claims in regards to CPT and ICD-9 codes and send out in a timely manner to insurance carriers.
  • Ability to interpret various Explanation of Benefits.
  • Audit account history showing insurance denials to resolve balances to the highest allowable for CPL and to fully utilize our patient’s benefits.
  • Audit Aged Trial Balance Reports. Contact insurance carriers regarding rejections and pending claims to resolve and confirm claims have been received.
  • Ability to generate demand claims for appeals to insurance carriers.
  • Strong data entry skills, with the ability to meet production guidelines as set by the Accounts Receivable Director.
  • Ability to stay work focused and perform job duties efficiently and accurately. Must have strong organizational skills.
  • Employee must comply with Clinical Pathology Labs’ compliance policies and procedures.
  • Duties include but are not limited to the above mentioned responsibilities.

Qualifications

Education:  High School Diploma or GED

 

Scope:  Respects and maintains the confidentiality of information relative to the laboratory.  Adheres to all accounts receivable policies, procedures and compliance guidelines.  Works with minimal direction, consults with Team-leader or Supervisor as needed.

 

Experience:  Preferred at least two years in standard insurance or HMO plans in a multitask environment, including customer service.  Strong background in coding procedures and data entry skills preferred.  Lab billing and bilingual skills a plus.

 

Skills:  Ability to communicate effectively at all levels within the company and with patients and physician office staff.  Knowledge of microcomputer technology and terminology.  Ability to type and demonstrate 10 key proficiency and current departmental standards is required.  Develop effective and harmonious work habits and relationships.  Ability to read and comprehend English.

Additional Information

 
Must be able to successfully complete pre-employment background check and drug screen, EOE