Senior Insurance Follow Up Specialist

Job Description

University of Toledo Physicians is seeking a Senior Insurance Follow Up Specialist to join our team. In this role, you will play a key part in driving resolution and promoting peak performance in delivering world-class revenue cycle outcomes. The ideal candidate will document responses, exhibit strong communication skills, and manage claims to meet productivity standards. Additionally, maintaining confidentiality and actively participating in process improvement planning are essential to success. This position also requires an understanding of HIPAA policies and procedures and the ability to perform mathematical calculations.

Responsibilities

• Document all responses and actions taken to reach claim or account resolution in the practice management system.
• Exhibit strong communication skills and positive attitude with internal and external customers.
• Follow workflow process to ensure correct registration, coding, payment/adjustment posting, and insurance processing of claims.
• Conduct verbal and written inquiries to determine reasons for unpaid/denied claims to reach resolution.
• Successfully manage claims in assigned worklists to meet/exceed productivity standards.
• Participate as a team member by performing additional assignments not directly related to the job description when workload requires.
• Select priorities and organize work and time to meet them in order of importance.
• Recognize and research problematic trends regarding non-payment in an effort to implement preventive measures to increase velocity of cash collections.
• Travel to practice locations to provide on-site support and participate in regular meetings with practice leadership to promote positive revenue cycle performance outcomes.
• Maintain the confidentiality of all patient records and accounts.
• Actively participate in staff meetings and process improvement planning sessions.
• Maintain work area in a clean and orderly fashion making sure all source documents are stored electronically on the shared network.

Requirements

• High School diploma or equivalent.
• 2+ years in resolving insurance denials and/or revenue cycle.
• Basic understanding of insurance requirements and regulations, contract benefits, credit and collection procedures, financial assistance programs, as well as familiarity with medical terminology.
• Advanced reading, writing, and oral communication skills.
• Analytical and critical thinking ability to diagnose account issues and active listening skills to provide service excellence.
• Demonstrated proficiency in data entry and computers.

Preferred Qualifications

• Knowledge of CPT and ICD terminology.
• Familiarity with billing software.
• EPIC experience.