Job Information
TEKsystems Appeals/Denials Specialist in Plano, Texas
Required:
2+ years of Insurance follow-up, denials/appeals experience (Medical A/R)
Hospital/facility collections experience
Description:
Responsible for A/R, and mail follow-up on amounts due from Payor’s, and third-party’s on a timely basis in accordance with CBO policies for facilities assigned. Responsibility for timely collections and third-party follow-up. Performs other related duties as assigned or requested. This is a non-exempt position. (This is not a patient collections position)
• Respond to payor’s by phone, or correspondence concerning underpaid, or non-paid account balances.
• Assists with all call types, correspondence and concerns regarding patient accounts.
• Refers rebill requests to the billing department timely.
• Maintains tickler file of accounts, following up by telephone, correspondence, on underpaid, or non-paid balances.
• Refers accounts to Supervisor/Manager, or CBO Director for write-off consideration, agency or attorney referral.
• Responsible for managing CBO Aging Report properly to insure appeals are followed up timely to prevent past filing deadlines.
• Communicates all denial write offs to Collection Supervisor, and Collections Manger.
• Aggressively works aged accounts to reduce bad debt A/R days.
• Meets corporate goals monthly on collections.
• Works with others as a team player, as well as supporting staff, and hospital/clinic staff.
• Work minimum 18 collection accounts daily.
• Investigates refund/credit, recoupment balances as necessary
• Utilizing all payor web sites available to increase efficiency of collections.
• Responsible for timely medical records requests and submission of appeals
• Maintain adequately trained staff to achieve daily productivity requirements
• Responsible for workflow management within the Collection Team and recommendations for process improvement
• Assist in coaching and development as mentor for new training initiatives
• Work collaboratively with leadership and other team leaders to confirm i.e. provide trending solutions
• File complaints when appropriate for delays in reimbursements, discrepancy’s in reimbursements, or under paid accounts
• Interpretation of Managed Care Contracts
Work collaboratively with team members and staff outside of the CBO to resolve issues on accounts. Including but, not limited to Managed Care, Reimbursement, Clinical, Admissions, Facility Business Office Manager, Coding, Case Management, HIM and Charge Master Departments.
Skills:
Payment posting, Collection, Medical collections, Medical, Payment poster, Data entry, Customer service, Medical billing, Call center, medicaid, Collection calls, Revenue cycle, outpatient, Outbound calls, Accounts receivable, Cash postings, Collections customer service, 50 wpm, Medical insurance, Insurance follow up, Icd-10, Medical terminology
Experience Level:
Intermediate Level
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.