Denials & Follow-up Representative - Professional Partnerships

This is a fully remote position, open to applicants in Louisiana.

📋 Description

• Address unresolved insurance account receivables.

• Execute collection and billing functions related to account resolution.

• Interact with Government and Commercial payors, clients, reimbursement vendors, and patients.

• Investigate accounts using both internal and external resources, including phone and payor websites, to ascertain account status and secure payment.

• Confirm and update insurance and demographic details to eliminate payment obstacles.

• Follow up with payors and monitor claim status throughout the payment cycle.

• Challenge denials and assess when further research or review of appeals is necessary.

• Maintain awareness of various payor guidelines to guarantee precise reimbursement.

• Recognize trends leading to account challenges and suggest recommendations for system enhancements or modifications.

• Stay informed about relevant laws, accreditation standards, and regulatory obligations to ensure compliance.

• Report any known or suspected unethical behavior and concerns regarding patient, employee safety, privacy, or compliance.

⛳️ Requirements

• High School diploma or equivalent is mandatory.

• At least 1 year of relevant experience in a hospital, clinic, medical office, business services/revenue cycle, front-line registration, financial counseling, banking, or customer service position.

• Proficient computer skills and dexterity for data entry and retrieval.

• Strong verbal and written communication abilities.

• Competence with Windows-based applications, keyboard, and role-specific software programs.

• Excellent interpersonal skills.

• Capacity to multitask effectively.

• Skill in performing well in a fast-paced, constantly changing environment.

• Ability to maintain composure and professionalism in high-pressure or stressful discussions regarding patient finances and medical issues.

• Reliable transportation for travel to other facilities as needed.

• Prior experience with the EPIC system is preferred.

• An Associate's degree or Bachelor's degree is preferred.

• Ability to adhere to applicable laws, accreditation standards, and regulatory mandates.

🏝️ Benefits

• Flexible remote work options.

• Reasonable accommodations available for qualified individuals with disabilities.

• Commitment to equal opportunity employment.

• Support for accessibility and application-process accommodations.