White Plains Hospital
Insurance Follow-Up Representative
White Plains Hospital, White Plains, New York, United States
Overview
At White Plains Hospital, you have an opportunity to work side-by-side with some of the most talented people in the world. We have been widely recognized for our exceptional culture, world-class physicians, Magnet-designated nurses and passionate employees who make a real difference in our community. With tremendous growth opportunities, great benefits, and flexible work schedules, it is no wonder why we are consistently recognized as a
Great Place to Work . Position Summary
Responsible for initiating follow-up to third-party payers on outstanding accounts and reviewing insurance correspondence and responding in a timely manner. Responsible for supplying third-party payers with appropriate billing information in order to adjudicate a claim. Responsible for assuring appropriate payment received in accordance with contract terms, reporting trends and collaborating with denials and variance teams to assure prompt and accurate payments. This position involves collecting and managing accounts, following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims when appropriate. Essential Functions and Responsibilities
Understands and adheres to the WPH Performance Standards, Policies and Behaviors Completes review of third-party outstanding balances and takes appropriate steps to resolve and reconcile outstanding balances Processes patient and insurance refunds Reviews open accounts for reconciliation and next steps to resolve open balances Review cases with provider representative liaison to assure escalation and processing of outstanding balances Contact payors and patients as needed to resolve open balances and account issues Responsible for reviewing assigned work queues and ensuring all accounts are worked timely, especially high dollar and aged accounts Reviews correspondence for appropriate action to resolve accounts Assure clear and concise notes within the EMR for all transactions Completes associated actions within the EMR such as insurance updates, adjustments and allowances as needed Escalates issues to management and provider representatives regarding incorrect payer processing, contract issues and/or trends Communicate with third-party representatives relaying issues and discussing payment expectations Take appropriate actions to resolve issues in a way that results in payment and/or complete closure of insurance balance Assure payor plan types and policy numbers are updated accurately within the EMR Collaborates with teammates and vendors as needed to reconcile and resolve outstanding accounts Review of claims to assure payers process claims timely and according to contract provisions Responsible for timely completion of projects and tasks as assigned by management and feedback on outcomes Responsible for ensuring productivity measures are met daily Performs all other related duties as assigned Education & Experience Requirements
High School Graduate or GED required 2–5 years previous patient accounting and insurance follow-up experience (hospital), preferred Knowledge of medical terminology required Familiarity with electronic medical record system, EPIC preferred Proficiency with Microsoft Office/Excel to include PIVOTS and vlookup, intermediate level required Must be detail-oriented, able to solve problems, multitask and perform various duties on demand Certified Patient Financial Services Specialist (CPFSS) certificate required Effective 12/1/2022, the HBI (Healthcare Business Insights) one-time certification course is required and must be completed during the onboarding period and prior to the start date. Core Competencies
Teamwork, communication skills, problem-solving, adaptability Must be able to speak, write, understand and communicate the English language Effectively communicate with internal and external customers Retains composure under stress Integrity to handle the confidential aspects of work Physical/Mental Demands, Requirements & Work Environment
May be exposed to chemicals necessary to perform required tasks. The hospital SDS is available through the intranet. This is standard for all Job Descriptions. Must be able to remain in a stationary position at least 50% of the time The person in this position may occasionally move about inside the office to access file cabinets, office machinery, etc. Constantly operate a computer and other office productivity machinery, such as calculators, copy machines and computer printers The person in this position will need to communicate with insurance plans and patients that may have questions. They must be able to accurately exchange information in these situations. Salary
Salary Range (based on Full Time): $53,187.74 - $80,782.07 Seniority level
Entry level Employment type
Full-time Job function
Sales and Business Development Industries
Hospitals and Health Care
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At White Plains Hospital, you have an opportunity to work side-by-side with some of the most talented people in the world. We have been widely recognized for our exceptional culture, world-class physicians, Magnet-designated nurses and passionate employees who make a real difference in our community. With tremendous growth opportunities, great benefits, and flexible work schedules, it is no wonder why we are consistently recognized as a
Great Place to Work . Position Summary
Responsible for initiating follow-up to third-party payers on outstanding accounts and reviewing insurance correspondence and responding in a timely manner. Responsible for supplying third-party payers with appropriate billing information in order to adjudicate a claim. Responsible for assuring appropriate payment received in accordance with contract terms, reporting trends and collaborating with denials and variance teams to assure prompt and accurate payments. This position involves collecting and managing accounts, following up with insurance companies, reconciling accounts, filing corrected claims, appealing claims when appropriate. Essential Functions and Responsibilities
Understands and adheres to the WPH Performance Standards, Policies and Behaviors Completes review of third-party outstanding balances and takes appropriate steps to resolve and reconcile outstanding balances Processes patient and insurance refunds Reviews open accounts for reconciliation and next steps to resolve open balances Review cases with provider representative liaison to assure escalation and processing of outstanding balances Contact payors and patients as needed to resolve open balances and account issues Responsible for reviewing assigned work queues and ensuring all accounts are worked timely, especially high dollar and aged accounts Reviews correspondence for appropriate action to resolve accounts Assure clear and concise notes within the EMR for all transactions Completes associated actions within the EMR such as insurance updates, adjustments and allowances as needed Escalates issues to management and provider representatives regarding incorrect payer processing, contract issues and/or trends Communicate with third-party representatives relaying issues and discussing payment expectations Take appropriate actions to resolve issues in a way that results in payment and/or complete closure of insurance balance Assure payor plan types and policy numbers are updated accurately within the EMR Collaborates with teammates and vendors as needed to reconcile and resolve outstanding accounts Review of claims to assure payers process claims timely and according to contract provisions Responsible for timely completion of projects and tasks as assigned by management and feedback on outcomes Responsible for ensuring productivity measures are met daily Performs all other related duties as assigned Education & Experience Requirements
High School Graduate or GED required 2–5 years previous patient accounting and insurance follow-up experience (hospital), preferred Knowledge of medical terminology required Familiarity with electronic medical record system, EPIC preferred Proficiency with Microsoft Office/Excel to include PIVOTS and vlookup, intermediate level required Must be detail-oriented, able to solve problems, multitask and perform various duties on demand Certified Patient Financial Services Specialist (CPFSS) certificate required Effective 12/1/2022, the HBI (Healthcare Business Insights) one-time certification course is required and must be completed during the onboarding period and prior to the start date. Core Competencies
Teamwork, communication skills, problem-solving, adaptability Must be able to speak, write, understand and communicate the English language Effectively communicate with internal and external customers Retains composure under stress Integrity to handle the confidential aspects of work Physical/Mental Demands, Requirements & Work Environment
May be exposed to chemicals necessary to perform required tasks. The hospital SDS is available through the intranet. This is standard for all Job Descriptions. Must be able to remain in a stationary position at least 50% of the time The person in this position may occasionally move about inside the office to access file cabinets, office machinery, etc. Constantly operate a computer and other office productivity machinery, such as calculators, copy machines and computer printers The person in this position will need to communicate with insurance plans and patients that may have questions. They must be able to accurately exchange information in these situations. Salary
Salary Range (based on Full Time): $53,187.74 - $80,782.07 Seniority level
Entry level Employment type
Full-time Job function
Sales and Business Development Industries
Hospitals and Health Care
#J-18808-Ljbffr