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Insurance Follow Up Representative

Facility: CHS Services Inc Location: Melville, NY Department: Billing/Follow up Category: Administrative / Business Support Schedule: Full Time Shift: Day shift Hours: M-F 8-4 ReqNum: 6020928

Catholic Health Services of Long Island (CHS) is an integrated health care delivery system with some of the region's finest health and human services agencies. CHS includes six hospitals, three skilled nursing facilities, a regional home nursing service, hospice and a multiservice, community-based agency for persons with special needs. Under the sponsorship of the Diocese of Rockville Centre, CHS serves hundreds of thousands of Long Islanders each year, providing care that extends from the beginning of life to helping people live their final years in comfort, grace and dignity.

Under the direction of the Physician Revenue Realization Manager, the Insurance Follow-Up Representative is responsible for investigating claims status with insurance carriers, correcting and resubmitting denied claims in the EPIC billing system.

Responsibilities:

  • Performs follow up on all outstanding accounts assigned in accordance with established standards and procedures.
  • Determines reason for denial and appeals accounts as necessary.
  • Reviews and edits any rejections stemming from electronic billing submissions and corrects and resubmits claims.
  • Verifies accuracy of patient insurance and demographic information.
  • Generates bills to patients for services not covered by insurance.
  • Investigates over-payments and takes appropriate action to resolve. Initiates refund requests in accordance with departmental procedures.
  • Responds to requests for information and telephone inquiries from patients, insurance carriers, and outside agencies in a courteous manner.
  • Send secondary claims to appropriate payors.

Requirements:

  • High School diploma or equivalent required.
  • Strong knowledge of medical insurance and healthcare billing
  • Establishes and demonstrates competency in accounts receivable systems and associated applications
  • Ability to communicate effectively with insurance carriers, patients, and co-workers
  • Ability to comply with procedural guidelines and instructions and to solicit assistance when situations arise that deviate from the norm.
  • Excellent verbal and auditory skills are required for communicating with internal staff, customers and representatives from external departments and agencies.
  • Minimum of 3 years of Physician Billing experience, including insurance carrier follow up and customer service, required.

At Catholic Health Services of Long Island your well-being comes first, with comprehensive compensation and benefits; our offerings go beyond the basics. In addition to multiple medical plans, life insurance, generous paid time off and flexible spending accounts, we also offer substantial tuition reimbursement, an employer funded pension plan and several savings plan options for your future.

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  • Administrative / Business Support, Melville, New York, United StatesRemove