Fairview Health Services Insurance Billing and Follow-Up Rep in St. Paul, Minnesota

Overview

Provides daily management of claims processing and submission of third party claims. Performs regular and consistent follow up, denial management, correction and/or reprocessing claims as necessary to ensure timely resolution.

Responsibilities

  • Performs billing functions to review and take necessary actions to resolve billing errors ensuring clean claim submission

  • Performs charge corrections per departmental requests

  • Works directly with third party payers, internal and external customers, toward effective and efficient claims resolution

  • Responds to Customer Service inquires

  • Maintains a thorough knowledge of third party billing and collection requirements for payers assigned

  • Submits replacement, cancel, and appeal, claims to third party payers

  • Utilizes all resources available, including electronic inquiries to verify eligibility, and claim status

  • Exercises good judgement towards account resolution and documents all activity on account in clear, accurate, and consistent manner

  • Contacts patient for additional information in order to have claims processed and paid in a timely manner

  • Perform due diligence to contact patient by phone and/or sending a letter

  • Advises manager/coordinator of any billing errors, third party payer trends, denials, or payment fluctuation, to ensure proper handling and escalation when necessary

  • Meets departmental productivity and quality assurance standards in accordance with departmental policies

  • Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures and standards

  • Actively participates in creating and implementing improvements

  • Performs other responsibilities as needed/assigned

Qualifications

  • High school graduate or equivalent

  • Minimum 2 years office experience, preferably in a health care setting

  • ICD-9 10 Coding experience helpful

  • Attention to Detail: Achieves thoroughness and accuracy when accomplishing a task

  • Computer Skills Basic: Ability to use a computer and applications that are associated with performing basic work tasks (navigate in Windows, Outlook, etc)

  • Data Entry: Skilled in entering data and calculating items for processing; input of data into computer systems

  • Interpersonal Communication: Skilled in developing effective rapport with customers, co-workers, or families, actively listening to develop a positive connection

  • Math Basic Skills: Knowledge and skills related to applying mathematical tools and methods for routine calculations

  • Records Management: Knowledge of appropriate data collection policy and procedures, filing systems, data management systems, and programs

  • Ability to compile, assimilate, organize, and store printed and electronic information

  • Written Communication: Ability to organize and express information and ideas in written form to individuals as well as groups

  • Construct messages that are clear and convincing

About HealthEast

At HealthEast, our patients are our neighbors and we are dedicated to their, and our, optimal health and well-being. We are guided by our faith-based heritage, a call to healing that respects the dignity and culture of every person. We empower our patients with user-friendly access to their health information, dependable service, and affordable, high-quality care.

We put new, more efficient models of care into practice, allowing our 7,500 employees and 850 physicians to focus on what’s important: providing compassionate health care that puts the patient and their needs first. With 14 clinics, home care, a medical transportation center, and four hospitals — Bethesda Hospital, St. John’s Hospital, St. Joseph’s Hospital, and Woodwinds Health Campus — we provide excellent family health and specialization, including primary, maternity, orthopaedics and post-acute care.

Job ID 2018-10901

Category Accounting & Finance

Contract Status NH

FTE 1.00

Shift Days

HealthEast is an Equal Opportunity Employer. HealthEast will not discriminate in public accommodation, or employment on the basis of race, color, creed, religion, national origin, sex, marital status, status with regard to public assistance, membership or activity in a local commission, disability, sexual orientation, gender identity or expression, age or genetic information.