Denials Follow Up Representative

Adecco Staffing is assisting a local client recruiting for a Denials Follow Up Representative in Parsipanny, NJ. The Denials Follow Up Representative opportunity is a permanent position with the client.
 

Job Purpose

The representative is responsible for collections, account follow up, noting clients systems where appropriate, and billing allowance posting for the accounts assigned to them.

Duties and Responsibilities

 

  • Follow-up with payers to ensure timely resolution of all outstanding clinical appeals, via phone, emails, fax or websites.
  • Ability to identify and correct billing errors and resubmit corrected claims to Insurance carriers.
  • Ability to work a minimum of 25+ accounts per day
  • Working knowledge of the insurance follow-up process with understanding of the fundamental concepts in healthcare reimbursement methodologies
  • Ability to review and interpret provider contracts to determine discrepancies in pricing/reimbursements
  • Ability to utilize web base applications: Navinet, Availity, and individual Online Portals for claim status, authorization status, eligibility, appeals and reconsiderations.
  • Identify and report underpayments and denial trends
  • Initiate appeals when necessary
  • Knowledge of basic coding guidelines
  • Knowledge of healthcare claims processing including: ICD-9, CPT, and HCPC codes, as well as UB-04
  • Knowledge of Explanation of Benefits (EOBs) and remittance advices (ERAs)
  • Understanding of reasons for payment errors, denials and underpayments
  • Strong analytical/problem solving skills
  • Ability to manage multiple hospital/clients and systems
  • Perform special projects and other duties as needed. Assists with special projects by utilizing excel spreadsheets, and the ability to communicate results.
  • Ability to analyze, identify and resolve issues causing payer payment delays
  • Act cooperatively and courteously with patients, visitors, co-workers, management and clients.
  • Maintain confidentiality at all times
  • Adheres to the policies and procedures established for the client/team
  • Maintain a professional attitude
  • Meets and maintains quality standards established in departmental policies
  • Understand and comply with Information Security and HIPAA policies and procedures at all times
  • Use, protect and disclose patients protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
  • Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties.
  • Other duties as assigned by the management team
 

Qualifications

 

  • 3 years’ experience in insurance collections, including submitting and following up on claims
  • Experience in Hospital billing
  • Ability to work well individually and in a team environment.
  • Proficiency with Microsoft Office
  • Strong communication skills/oral and written

Click on "Apply Now" to be considered for Denials Follow Up Representative Position. 

Adecco Staffing is an Equal Opportunity Employer Minorities/Women/Veterans/Disabled

 

  • Apply with Adecco

Reference number US_EN_99_028124_490509