Brown University Health · 1 day ago
Claims Follow Up Rep
Providence, RI
Full-time
Onsite
Entry Level
$19.97/hr - $32.96/hr
1+ years expBrown University Health is a large physician multi-specialty practice seeking a Claims Follow Up Representative. This role involves following up on outstanding claims, correcting denied claims, and ensuring compliance with healthcare regulations.
EducationHealth CareMedicalUniversities
Responsibilities
Review all denied claims, correct them in the system and send corrected appealed claims as written correspondence, fax or via electronic submission
Identify and analyze denials and enact corrective measures as needed to effectively communicate and resolve payer errors
Continually maintain knowledge of payer specific updates via payer’s listservs, provider updates, webinars, meetings and websites
Understand and maintain compliance with HIPAA guidelines when handling patient information
Contact internal departments to acquire missing or erroneous information on a claim resulting in adjudication delays or denials
Report to supervisor identification of denial trends resulting in revenue delays
Answers telephone inquiries from 3rd party payers; refer all unusual requests to supervisor
Retrieve appropriate medical records documentation based on third party requests
Refer all accounts to supervisor for additional review if the account cannot be resolved according to normal procedures
Work with management to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department
Maintain quality assurance, safety, environmental and infection control in accordance with established policies, procedures, and objectives of the system and affiliates
Perform other related duties as required
Qualification
Required
Equivalent to a high school graduate
Knowledge of 3rd party billing to include ICD, CPT, HCPCS and 1500 claim forms
Demonstrated skills in critical thinking, diplomacy and relationship-building
Highly developed communication skills, successfully demonstrated in effectively working with a wide variety of people in both individual and team settings
Demonstrated problem-solving and inductive reasoning skills which manifest themselves in creative solutions for operational inefficiencies
One to three years of relevant experience in professional billing preferred
Experience with Epic a plus
Company
Brown University Health
Brown University Health provides an integrated academic health system offering hospital services, outpatient care and clinical education.
10001+ employees
Funding
Current Stage
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