Follow-up Rep 2 Job at Waterbury Hospital

Waterbury Hospital Waterbury, CT 06708

SCOPE OF POSITION: The Follow-up Rep 2 position is responsible for the reimbursement of claims from various insurance companies and or government payers. The position will maintain proper follow-up on assigned accounts using department's collection guidelines, policies, procedures, government rules and regulations and managed care contracts.



RESPONSIBILITIES:


  • Responsible to assign accounts and meet department's productivity expectation.
  • Monitors and/or follow-up accounts by using insurance company's web-portal and/or make telephone calls to assure timely resolution and accurate reimbursement.
  • Responsible for identifying follow up problems and issues
  • Contacts the insurance companies to inquire about denial reasons to ensure proper resolution is applied.
  • Monitors and/or follows-up on accounts with precise documentation and calculations.
  • Utilizes the previous documentation comments in order to follow up in the appropriate manner.
  • Utilizes aging reports to monitor each account and resolves barriers to assure timely and correct payment
  • Reviews remittance codes from EOB's and RA's to ensure appropriate payment or to identify denials or non-payment
  • Works the current hospital information systems queues/processes set up for their specific assignment/payers as directed by Leadership.
  • Refers all payer issues/problems to Leadership in a timely manner with specific examples.
  • Responsible for complete, accurate, and timely documentation of all follow-up pertaining to the resolution of the account within the current hospital information systems patient financial record
  • Provides support to Managed Care Collector 1 as needed
  • Performs other duties as assigned



REQUIREMENTS:


  • Minimum of 3 year's experience as a Follow Up Rep 1.
  • Must have expertise with all managed care contracts, action plan procedures, government intermediaries, and has knowledge of current regulatory requirements
  • Ability to perform complex mathematical calculations to adjudicate accounts appropriately.
  • Ability to analyze and adjudicate complicated contractual arrangements
  • Proficient with Microsoft Excel, Word, and PowerPoint applications
  • Must demonstrate excellent communication skills while dealing with confidential financial matters


Location: Waterbury Hospital · Patient Accts/Financial Serv
Schedule: Per Diem, Days, Per Diem hours between 8am - 4:30p




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