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Follow Up Specialist - Springfield Illinois
Company: Memorial Health Location: Springfield, Illinois
Posted On: 04/20/2024
Overview Follows up on outstanding payments due on all types of open medical insurance claims, i.e., managed care and commercial. Coordinates activities with external insurance companies for the resolution of patient account balances. Ensures compliance with managed care guidelines and MMC organizational policies. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values. Qualifications Education: - Education equivalent to graduation from high school or GED is required.
Experience: - Two or more years as an Account Follow-Up Specialist, or comparable years of medical insurance and/or health care billing experience is required. Possesses the technical knowledge to independently process claims of any denomination, type, and complexity is required.
Other Knowledge/Skills/Abilities: - Demonstrates thorough knowledge of the electronic billing system, medical terminology, medical procedural (CPT) and diagnosis (ICD-9 CM) coding, DRGs and hospital billing claim form UB-04 is required.
- Demonstrates a thorough knowledge of contract management systems and Blue Cross and Tricare guidelines.
- Basic working knowledge of personal computers and their associate user software is required. Experience with Microsoft Office products Word and Excel is preferred.
- Ability to work within the guidelines of defined managed care contract policy provisions and company procedures.
- Demonstrated ability to work successfully with internal customers and external contacts is required.
- Possesses highly-developed prioritization and organization skills and critical thinking and problem solving ability.
- Demonstrates excellent communication skills, including telephone etiquette, and keyboarding and basic math skills.
Responsibilities |
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