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Insurance Follow Up Associate - Hospital Managed Care - Office Park

Requisition #:  30308     
Name of Location:   Office Park (1455)

 

JOB SUMMARY

Meets all department collection and follow-up performance expectations. Completes assigned work in a timely fashion and reports any issues or obstacles to lead collector or patient accounts supervisor to ensure swift resolution. Identifies payor trends proactively in relation to zero payment, payment variance, billing, and denials. Works closely with other collectors and lead collectors in completing claims billing and follow-up collection activities. Completes projects as requested by patient accounts manager or patient accounts supervisor. Adheres to company and department attendance, basic work requirements, and other policies and procedures.

EDUCATION

  • High school diploma or equivalent

CERTIFICATION SUMMARY

  • No professional certifications required

EXPERIENCE*

  • One year of experience in insurance billing or collections, with a general knowledge of hospital business office functions

PREFERRED QUALIFICATIONS*

  • Some college
  • Two years of experience in insurance billing and/or collections, with a general knowledge of hospital business office functions
  • Knowledge of key Children's Healthcare of Atlanta patient accounting applications, e.g., Epic Resolute, Dentrix Dental, Clearinghouse, or comparable system

KNOWLEDGE SKILLS & ABILITIES*

  • Knowledge of third-party requirements and policies, including Medicaid, Managed Care, Blue Cross Blue Shield, care management organizations, health maintenance organizations, preferred provider organizations, commercial payors, and self-pay
  • Must have excellent telephone communication and customer service skills
  • Excellent written and verbal communications skills
  • Familiar with medical terminology, including diagnosis and procedure codes
  • Must be able to meet department/individual goals
  • Must be able to type 45 words per minute
  • Must be able to operate personal computer-based systems, including working knowledge of word processing, spreadsheet, and billing software

JOB RESPONSIBILITIES*

  1. Performs daily billing of claims to third-party insurance following the guidelines of the UB04 and HCFA 1500 manual.
  2. Ensures that special billing needs by payor are performed to prevent denial of claims and delay in payment.
  3. Prepares and submits all final bill claims, secondary claims, rebills, and late charges on a daily basis, maintaining a current status.
  4. Performs routine follow-up on unpaid insurance claims, taking appropriate action to resolve problems causing delay in reimbursement.
  5. Documents all telephone and correspondent communications with third-party payors and guarantors thoroughly via online activity codes.
  6. Prioritizes and works proactively on accounts in assigned work queue to ensure all accounts are submitted in a timely manner.
  7. Complies with department workflows and routines.
  8. Contacts guarantors and other insured parties when additional information is needed, and takes appropriate action to resolve any delay in reimbursement.
  9. Works correspondence daily, including adding Medicaid eligibility to self-pay and commercial accounts.
  10. Works returned mail on high-dollar accounts and correspondences from third-party payors.
  11. Takes appropriate action to resolve all insurance, bad debt, and/or self-pay unpaid balances.

SYSTEM RESPONSIBILITIES*

Safety: Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system.

 

Compliance: Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process. Maintains records of compliance activities and reports compliance activities to the Compliance Office.

 

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification.  They are not intended to be an exhaustive list of all job duties performed by the personnel so classified.

PHYSICAL DEMANDS*

Ability to lift up to 15 lbs independently not to exceed 50 lbs without assistance

Bending/Stooping - Occasionally (activity or condition exists up to 1/3 of time)

Climbing - Not Present

Hearing/Speaking - Effective communication with employees, supervisors/managers and staff. Effective communications with patients and visitors, as required.

Lifting - Occasionally (activity or condition exists up to 1/3 of time)

Pushing/Pulling - Occasionally (activity or condition exists up to 1/3 of time)

Sitting - Frequently (activity or condition exists from 1/3 to 2/3 of time)

Standing - Occasionally (activity or condition exists up to 1/3 of time)

Walking - Occasionally (activity or condition exists up to 1/3 of time)

WORKING CONDITIONS*

No potential for exposure to blood and body fluids

 

 

Location Address:  1455 Tullie Circle NE, Atlanta, GA  30329
Function:  Revenue Cycle - Patient Financial Services

 

Overview:

Children’s Healthcare of Atlanta is one of the largest pediatric clinical care providers in the country. We have a total of 638 licensed beds among our three hospitals and 28 neighborhood locations. We are home to the only Level 1 and 2 pediatric trauma centers in Georgia, and we treat about 60 percent of pediatric trauma patients in the state.

  • We are ranked as a top pediatric heart care and heart surgery program by US News & World Report.
  • Our 27-bed unit is one of the largest dedicated pediatric Cardiac Intensive Care Units (CICUs) in the Southeast.
  • We performed 634 cardiac surgeries in 2017. We are ranked No. 3 nationally in pediatric cardiac surgical and medical volumes.
  • Our Cardiac Stepdown Unit was recognized with a gold-level Beacon Award of Excellence. Our CICU was recognized with a silver-level Beacon Award of Excellence for nursing outcomes.
  • Our staff includes more than 50 pediatric cardiologists and three pediatric cardiothoracic surgeons.


Nearest Major Market: Atlanta

Job Segment: Medical, Clinic, EMR, Medicaid, Pediatric, Healthcare