Insurance Follow-up/Claims Specialist - Savannah

Job Description:

Optim Health System is seeking a full time Insurance Follow-up/Claims Specialist for our Savannah location. 

Job Requirements:

• Identifies delinquent accounts by printing an aging report for all accounts 91 days and older and reviewing each account for the date of last payment.
• Reviews aging account report via computer, at least 20 per day.  Notes must be typed in the collection module, printed daily and kept in a folder for supervisor to review at any given time.
• Performs collection actions including contacting patients by telephone, resubmitting claims to third party reimbursers and requesting Equifax letters.
• Makes a notation on each account after Equifax letter has been sent to the patient and make a follow up action on account after a two to three week period.
• Identify accounts with a balance over $100 that are uncollectable each month and submit to physician for approval to adjust account.  Accounts should be written on an adjustment form, the notes for each account should be printed and attached to a Doctors Action on Account form.  All of the information should be given to the supervisor for review.  The supervisor will then attaché the Uncollectable A/R letter and submit to the physician.  The billing specialist must make sure that the physician returns the accounts within the two-week period.
• Evaluates patient financial status and establishes budget payment plans as needed.
• Identifies and resolves patient billing complaints 
• Answers patient calls and document how the patient was helped in the collection module and print. (These notes should be kept separate from the Aging report notes).
• Helps answer the telephone on Night Mode 2. (Ringing overhead).
• Participates in educational activities. 
• Research and re-process mail from A/R department.
• Print and work the insurance pending accounts on the Delinquent Accounts with Appointments Report daily.  Call insurance company for status and fax and mail corrected claims when necessary.  Makes sure this is done when absent from work by coordinating with a co-worker.
• For Self-Pay accounts subsequently providing insurance coverage information, update account to reflect change and submit claims to insurance companies for payment.
• Rebill, print, fax and mail claims to insurance companies on appropriate accounts and change responsibility to the patient.
• Assist other personnel in the performance of their duties as assigned and as workload permits.  Function as a relief for other personnel in the office, as appropriate and to facilitate co-workers’ taking of time off.
• Prioritize work received and complete in a timely manner.
• Adds accounts to collection module bi-weekly. 
• File “proof of claim” forms for all appropriate Bankruptcy Notifications.
• Performs other work duties and assignments as required.

Optim Offers

• Competitive Pay
• Company Benefits
• Vacation, Personal Time Off, and Sick Leave
• Holiday Pay
• 401K Plan