AR Commercial Follow Up Specialist
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Job Description
AR Commercial Follow-Up Specialist resolving commercial payer claims for UofL Health’s integrated academic healthcare system. Managing accounts receivable follow-up, appeals, denials, and payment accuracy.
Responsibilities:
- Monitor commercial and specialty payer accounts receivable inventory to ensure timely follow-up and claims resolution
- Adhere to quality and productivity standards assigned by management
- Submit accounts for appeal where retroactive coverage has been obtained
- Identify payers submitted on paper rather than electronically and communicate opportunities to leadership
- Follow up on unpaid commercial and third-party payer claims
- Consistently follow up on high-dollar accounts until resolution
- Review and understand explanations of benefits and remittance advice
- Ensure statements are generated for patient responsibility amounts
- Utilize insurance websites to view and resolve claims
- Perform extensive account follow-up and provide analysis of problem accounts
- Document follow-up efforts clearly and concisely in the AR system
- Audit and research accounts, payment posting, and contractuals to confirm account balance accuracy
- Ensure medical record requests are documented and submitted timely
- Collaborate with the denials team on difficult or recurring denials
- Complete tasks by deadlines
- Identify and report trends that may provide insight into payment challenges
- Contact patients, physician offices, attorneys, and others by phone for additional claim information
- Attend seminars as requested
- Perform other duties as assigned
Requirements:
- High School Diploma or GED
- 1 year of patient registration, billing, or equivalent experience
- Working knowledge of medical and insurance terms is desirable
- Ability to review, comprehend, and discuss HCFA billing with insurance or government agencies
- Knowledge of general insurance requirements
- Experience working directly with EOBs and contractual adjustments
- General computer knowledge and experience working with electronic filing
- Ability to communicate verbally and in writing with professionalism
- Ability to meet productivity expectations
- Thorough knowledge of the Uniformed Bill
- Knowledge of timely filing limits set forth by various payers
- Knowledge of various payer websites for follow-up
- Thorough understanding of commercial payer eligibility, benefits, determining primary payer, and covered benefits
- Understanding of billing policies for auto and workers’ compensation and incarcerated patient payers
- Compliance with state and federal regulations
Benefits:
- Full-time employment
- First shift schedule (8:00 a.m.–4:30 p.m.)
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