Insurance Claims Representative

This is an on-site position located at the Birmingham Business Office. Summary Under general supervision, an AR Account Follow-Up Specialist is responsible for account follow-up for all assigned accounts, resolving billing problems and answering patient inquiries. Uses collection techniques to keep accounts receivable current including monitoring for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take appropriate action including completion of submissions, reconsiderations, appeals, and denial management to ensure payment is received timely. Essential Duties and Responsibilities • Performs audits of patient accounts to ensure accuracy and timely payment. • Follows up on insurance billing to ensure timely receipt of payments. • Demonstrates the ability to deal with patients and insurance companies regarding sensitive financial matters and recapture unpaid balances. • Receives and resolves patient billing complaints and questions; initiates adjustments as necessary; follows up on all zero payment explanations of benefits and exercises all options to obtain claim payments. • Reviews credit balance reports for correct recipient of refund. • Performs reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks. • Identifies problems on accounts and follows through to conclusion. • Responds to insurance companies requests for information in a prompt and professional manner. • Reviews EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends to supervisor. • Prepares write-off requests with appropriate documentation and submits to supervisor. • Processes insurance/patient correspondence. • Works with provided aging to monitor patient account aging and follows up appropriately. • Maintains confidentiality in regard to patient account status and the financial affairs of clinic/corporation. • Other relevant duties as assigned • Demonstrated knowledge of the federal, state, and local regulatory requirements around medical billing and coding as well as CMS and payer regulations. • Ability to work independently. • Able to manage multiple projects at once working efficiently and effectively under tight deadlines. • Experience with oncology billing experience highly desirable. Requirements • High school diploma • 1 plus years of experience • Experience in medical billing /insurance processing and balancing accounts