Denials And Appeals Specialist
Company: TEKsystems
Location: Plano
Posted on: April 24, 2024
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Job Description:
Required:
2+ years of Insurance follow-up, denials/appeals experience
(Medical A/R)
Hospital/facility collections experience
Description:
Responsible for A/R, and mail follow-up on amounts due from
Payor's, and third-party's on a timely basis in accordance with CBO
policies for facilities assigned. Responsibility for timely
collections and third-party follow-up. Performs other related
duties as assigned or requested. This is a non-exempt position.
(This is not a patient collections position)
--- Respond to payor's by phone, or correspondence concerning
underpaid, or non-paid account balances.
--- Assists with all call types, correspondence and concerns
regarding patient accounts.
--- Refers rebill requests to the billing department timely.
--- Maintains tickler file of accounts, following up by telephone,
correspondence, on underpaid, or non-paid balances.
--- Refers accounts to Supervisor/Manager, or CBO Director for
write-off consideration, agency or attorney referral.
--- Responsible for managing CBO Aging Report properly to insure
appeals are followed up timely to prevent past filing
deadlines.
--- Communicates all denial write offs to Collection Supervisor,
and Collections Manger.
--- Aggressively works aged accounts to reduce bad debt A/R
days.
--- Meets corporate goals monthly on collections.
--- Works with others as a team player, as well as supporting
staff, and hospital/clinic staff.
--- Work minimum 18 collection accounts daily.
--- Investigates refund/credit, recoupment balances as
necessary
--- Utilizing all payor web sites available to increase efficiency
of collections.
--- Responsible for timely medical records requests and submission
of appeals
--- Maintain adequately trained staff to achieve daily productivity
requirements
--- Responsible for workflow management within the Collection Team
and recommendations for process improvement
--- Assist in coaching and development as mentor for new training
initiatives
--- Work collaboratively with leadership and other team leaders to
confirm i.e. provide trending solutions
--- File complaints when appropriate for delays in reimbursements,
discrepancy's in reimbursements, or under paid accounts
--- Interpretation of Managed Care Contracts
Work collaboratively with team members and staff outside of the CBO
to resolve issues on accounts. Including but, not limited to
Managed Care, Reimbursement, Clinical, Admissions, Facility
Business Office Manager, Coding, Case Management, HIM and Charge
Master Departments.
Skills:
Payment posting, Collection, Medical collections, Medical, Payment
poster, Data entry, Customer service, Medical billing, Call center,
medicaid, Collection calls, Revenue cycle, outpatient, Outbound
calls, Accounts receivable, Cash postings, Collections customer
service, 50 wpm, Medical insurance, Insurance follow up, Icd-10,
Medical terminology
Experience Level:
Intermediate Level
About TEKsystems:
We're partners in transformation. We help clients activate ideas
and solutions to take advantage of a new world of opportunity. We
are a team of 80,000 strong, working with over 6,000 clients,
including 80% of the Fortune 500, across North America, Europe and
Asia. As an industry leader in Full-Stack Technology Services,
Talent Services, and real-world application, we work with
progressive leaders to drive change. That's the power of true
partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all
applications without regards to race, sex, age, color, religion,
national origin, veteran status, disability, sexual orientation,
gender identity, genetic information or any characteristic
protected by law.
Keywords: TEKsystems, Frisco , Denials And Appeals Specialist, Other , Plano, Texas
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