Payment Variance Follow Up Representative
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Job Description
Payment variance representative collecting outstanding insurance reimbursements for Med-Metrix. Analyzing underpayments, following up on claims, and initiating payer appeals.
Responsibilities:
- Follow up with payers via phone, email, fax, or websites to ensure timely resolution of outstanding claims
- Perform payment variance analysis to identify trends in underpaid claims
- Identify and report underpayments and denial trends
- Initiate appeals when necessary
- Interact cooperatively and courteously with patients, visitors, coworkers, management, and clients
- Maintain confidentiality and a professional attitude
- Use, protect, and disclose patients’ PHI in accordance with HIPAA standards
- Comply with Information Security and HIPAA policies and procedures
- Limit viewing of PHI to the minimum necessary to perform assigned duties
- Perform other duties as assigned
Requirements:
- High School Diploma or equivalent required
- 3 years’ experience in Commercial insurance collections, including submitting and following up on claims
- Experience in Hospital/Facility billing
- Working knowledge of the insurance follow-up process and fundamental concepts in healthcare reimbursement methodologies
- Detailed knowledge of Managed Care reimbursement methodologies
- Basic knowledge of healthcare claims processing, including ICD-9, CPT, HCPC codes, and UB-04
- Ability to analyze, identify, and resolve issues causing payer payment delays
- Proficiency with MS Office Suite
- Strong interpersonal, written, and verbal communication skills
- Strong problem-solving and creative skills; ability to exercise sound judgment and make decisions based on accurate and timely analyses
- High level of integrity and dependability, with a strong sense of urgency and results orientation
- Gracious and welcoming personality for customer service interaction
- Must possess a smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes
- Ability to follow directions, collaborate with others, and handle stress
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