[Hiring] Denials & Follow-up Rep @Ochsner Health

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Role Description

This job is primarily responsible for resolving all outstanding insurance account receivables. Responsibilities include, but are not limited to:

  • Performing collection and billing activities related to account resolution
  • Communicating with payors (Government and Commercial), clients, reimbursement vendors, and other external resources such as patients
  • Performing account research with internal and/or external resources via phone and payor websites to determine status of the account
  • Verifying and/or updating insurance and demographic information for accuracy
  • Following up with payors and checking claim status as needed
  • Appealing denials when needed throughout the payment process
  • Maintaining knowledge of differing payor guidelines to ensure accurate reimbursement
  • Identifying trends that may cause issues on assigned accounts and reporting to leader with recommendations for system improvements
  • Remaining knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements
  • Complying with the employer's Compliance & Privacy Program and Standards of Conduct

Qualifications

  • Required – High School diploma or equivalent
  • Preferred – Associates Degree or Bachelor Degree
  • Required – 1 year related experience in hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service
  • Preferred – Prior experience working with EPIC system

Requirements

  • Must have computer skills and dexterity required for data entry and retrieval of required job information
  • Effective verbal and written communication skills
  • Proficient with Windows-style applications, keyboard, and various software packages specific to role
  • Strong interpersonal skills
  • Ability to multi-task
  • Ability to perform effectively in a fast-paced, ever-changing environment
  • Ability to remain calm and professional in high pressure/stressful situations
  • Reliable transportation to travel to other facilities as needed

Physical and Environmental Demands

  • Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently
  • Normal routine involves no exposure to blood, body fluid or tissue
  • No occupational risk for exposure to communicable diseases
  • Potential occupational risk for exposure to hazardous medications or hazardous waste
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