Billing Follow-Up Representative

Summary

CompuNet Clinical Laboratories is a clinical laboratory organization seeking a Billing Follow-Up Representative. The role processes billing accounts, submits and follows up on claims, resolves denials and payment issues, and communicates with patients, clients, and insurance carriers. This is a full-time day-shift position located at the Core Lab in Moraine, Ohio, with remote shift availability.

Responsibilities

• Maintain organized workflow to allow efficient processing of accounts and to enable smooth transition of job duties during absences
• Follow department standard processes. Consult with immediate supervisor when questions regarding appropriate account processing arise
• Exhibit good customer service skills when dealing with internal and external customers. Project a positive image of the department and organization
• Actively engage in behaviors that foster teamwork within the department and organization
• Meet or exceed department standards for quantity and quality of work
• Possess working knowledge of relevant compliance regulations. Effectively apply this knowledge to daily job duties
• Comply with all departmental, company and regulatory policies and procedures
• Maintain statistical data as required
• Additional duties and projects as assigned
• Ability to accurately perform order entry
• Research and resolve any missing information from the Client orders
• Ability to use translation tools to enter codes received from other departments into the appropriate billing systems
• Strong communication skills needed for collaboration with both internal and external departments as well as patient/client calls
• Apply payment detail to client and patient accounts, including contractual disallowances, and patient copays/deductibles
• Review over payments, initiating refunds or correcting misapplied payments as appropriate
• Knowledge of reading and understanding various payer’s Explanation of Benefits
• Review un-adjudicated claim reports and contact insurance carriers to determine reason for non-response
• Perform follow-up as appropriate to resolve outstanding accounts
• Process Medicare denials for medical necessity and monitor payer rejections and denials for trends
• Review claim development reports for insurance denials; contact insurance carriers to determine denial reasons; works with carriers to rectify unpaid claims
• Ability to handle fast paced, high call volume environment with above average multi-tasking skills
• Possess strong focus on positive customer impact. Utilize verbal and written communication effectively
• Research collection accounts as requested by patients or collection agencies
• Review system error codes and make corrections to accounts

Skills

• High school graduate or equivalent required
• Sound reasoning ability and independent judgment
• Ability to work within specified deadlines and timetables
• Excellent communication and people skills
• Handle stressful situations in a calm manner
• Previous experience in medical billing environment preferred
• Working knowledge of Medicare and other third party claims processing, ICD-10 and HCPS/CPT coding and medical terminology highly desirable

Qualifications

Must Haves

• High school graduate or equivalent required
• Sound reasoning ability and independent judgment
• Ability to work within specified deadlines and timetables
• Excellent communication and people skills
• Handle stressful situations in a calm manner

Nice to Haves

• Previous experience in medical billing environment preferred
• Working knowledge of Medicare and other third party claims processing, ICD-10 and HCPS/CPT coding and medical terminology highly desirable

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Company-paid life insurance
• 403b match
• Paid holidays
• Vacation time
• Sick time
• Personal time
• Remote shift availability