Claims Follow Up

Claims Follow Up

Monday-Friday 8am-5pm

Essential Job Functions:

Responsible for performing claim research and electronic claims follow-up work with multiple insurance companies either by electronic system or phone depending on insurer, to resolve accounts which have been billed but remain unresolved.

Reviewing notes on client systems to see what work has already been performed.

Determining next steps by either using electronic tools or calling the insurance company to determine claim status, depending on insurer.

If no claim is on file, it will need to be re-billed electronically through the clients systems.

If a claim is rejected, find out why and make a determination if it can be re-billed with proper information, if it should be patient responsibility, or if it is a timely filing issue.

If coding needs to be changed, submit to appropriate group for review.

Work specific payers/insurers and accounts as assigned by management.

Responsible for submitting accounts to be written off or changed to patient responsibility.

Responsible for claim denials and determining how to resolve the claim either by correction, re-billing, or if it was rejected authorization issues.

Maintaining a productivity of 25 accounts/day with a 90% quality rating.

Additional Skills & Qualifications

– Experience in a hospital, physician business office or with a 3rd party vendor performing billing and claim follow-up work

– Thorough knowledge of medical terminology (EOBs, DRGs HCPCSs, CPT & ICD codes, etc.).

– Experience with UB04 forms.

– Working knowledge of medical billing systems and normal healthcare billing workflows.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

Medical, dental & vision

Critical Illness, Accident, and Hospital

401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available

Life Insurance (Voluntary Life & AD&D for the employee and dependents)

Short and long-term disability

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Time Off/Leave (PTO, Vacation or Sick Leave)

About TEKsystems:

Were partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. Thats the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.