UF Health
Insurance Specialist II | Ambulatory Revenue Cycle | Full-time | Days
UF Health, St Augustine
Overview
The Insurance Specialist II is responsible for follow up on new and outstanding accounts in a professional and consistent manner. Accurately document account statuses, notes, etc. in the AR management system. Maintains compliance with FDCPA, FCRA, HIPPA plus local, state and federal regulations. Demonstrates attention to detail, achieves the determined production and quality expectations and works well under pressure.
Responsibilities
Education / Training
Preferences:
Extensive working knowledge of insurance accounts receivable collections and claims follow up. Extensive working knowledge Florida payer guidelines and insurance carrier payment rules. Ability to appeal claims based on extensive working knowledge of how to solve payer/claim related issues. Familiarity with claim software and clearinghouse. Familiarity with both government and commercial insurance plans. Experience with denial and appeal process.
The Insurance Specialist II is responsible for follow up on new and outstanding accounts in a professional and consistent manner. Accurately document account statuses, notes, etc. in the AR management system. Maintains compliance with FDCPA, FCRA, HIPPA plus local, state and federal regulations. Demonstrates attention to detail, achieves the determined production and quality expectations and works well under pressure.
Responsibilities
- Responsible for claims processing and timely insurance follow up.
- Provides customer service to all patients and authorized representatives regarding patient accounts in accordance with practice protocol. Provides exceptional customer service with all payers.
- Relays information pertaining to billing, coding, managed care networks, insurance carriers and reimbursement to management. Recognizes trends in the aging reports and works with payers to decrease response/payment turnaround.
- Working knowledge of billing claims system.
- Review, understand, and work unpaid claim denials and rejections, makes necessary corrections through worklists and reporting tools. Conducts eligibility and denial reviews. Responds promptly to all correspondence (fax, email, telephone, mail) and ensures that all timely filing deadlines are met where applicable.
- Initiates appeal requests per payer guidelines in timely manner.
- Verifies all demographic and insurance information in patient registration and provides feedback to other front office staff members to ensure accuracy and timely reimbursement. Ability to research, understand and educate on payer contracts when needed.
- Monitors various payers bulletins and educational updates to provide information to appropriate team members.
- All other duties as assigned by department.
Education / Training
- High School Diploma/Equivalent
- 5 to 7 years Insurance Follow-up Denials, Appeals
Preferences:
Extensive working knowledge of insurance accounts receivable collections and claims follow up. Extensive working knowledge Florida payer guidelines and insurance carrier payment rules. Ability to appeal claims based on extensive working knowledge of how to solve payer/claim related issues. Familiarity with claim software and clearinghouse. Familiarity with both government and commercial insurance plans. Experience with denial and appeal process.