Perform follow-up activity on all accounts to ensure prompt resolution.

• Responsible for Follow-Up on all claims, including self-pay and commercial and government payor claims.
• Maintains a working knowledge of other positions in the PFS office.
• Serves as backup for biller, cash poster, and charge poster.
• Maintain knowledge of billing/collecting laws and continue education and training on proper billing and coding procedures.
• Aggressively works to reduce AR by following up on all accounts by telephone, letters, email, or any other means available.
• Works on rapid resolution of issues between facility, doctor’s office, patient, or other interested parties.
• Works denials and underpayments as assigned. 
• Helps with appeals as assigned.
• Sorts, responds, and files correspondence.
• Make any corrections to demographics or insurance information as necessary.
• Documents all conversations, mailings, etc., on the computer system.
• Services as a customer service rep by answering incoming calls or visits from patients, insurance companies, doctor’s offices, or other interested parties by answering questions or concerns or directing the appropriate person who can help.
• Receives payments via telephone and processes accordingly.
• Performs other projects/duties as assigned.
• As an employee of SHOLA, you are responsible for ensuring we comply with all federal and state privacy protection laws and regulations (HIPAA). You must recognize protected health information (PHI) that requires protection, determine when it is permissible to access, use, or disclose PHI, and reduce the risk of impermissible access to, use, or disclosure of PHI.
• Exceptional patient satisfaction is the expected culture at SHOLA. Each employee is responsible for delivering exceptional patient satisfaction in all encounters with patients, families, and visitors. You are responsible for always holding yourself and your peers accountable for providing excellent patient satisfaction.  
• Responsible for checking each assigned payer’s remittances against the system’s expected reimbursement. Research any variances and appeal remittance if necessary. Promptly report any trends or issues to the Revenue Cycle Director.

The statements mentioned above outline the general duties necessary to describe the essential functions of this position. However, they are not meant to be considered a comprehensive description of all the work requirements that may be inherent in the position.

Education: High school education or equivalent. Two years of college preferred. 

Experience: A minimum of two (2) years of experience performing follow-up activities in a medical office environment is required. Additional experience in billing hospital claims is strongly desired. 

Licenses/Certificates: None

Special Skills: Acute attention to detail; working knowledge of Excel and Word; excellent math and reasoning skills; knowledge of claims processing/billing (CPT-4 and ICD-10 codes) and medical terminology. Must have good customer service, communication (both oral and written), organizational skills, and basic computer skills.

Report To: Business Office Coordinator

Positions reporting directly to this position: None