Account Follow-up Specialist II

Legacy Health; Portland (OR); On-site; USD 30,000 - 43,000; Full time

Job summary

Legacy Health is seeking an Account Follow-up Specialist to manage delinquent payments in a complex, multi-payor environment. You will analyze patient accounts, verify billing details, and coordinate with payors to optimize reimbursements.

Ideal candidates have two years of healthcare billing experience, familiarity with UB-04 and CMS-1500 forms, and strong communication skills to work with patients, providers, and insurers.

Qualifications

• High school diploma or equivalent.
• Two years of healthcare billing/collections experience.
• Knowledge of UB-04 and CMS-1500 claims and reimbursement rules.

Responsibilities

• Resolves delinquent payment issues for complex accounts.
• Investigates patient accounts, medical records, and bills.
• Analyzes accounts to determine best follow-up for reimbursement.
• Removes barriers to processing claims and resubmits when needed.
• Submits reconsiderations or appeals for denied claims.

Skills

Problem solving

Decision making

Multi-payor knowledge

Billing regulations

Eligibility review

EMR familiarity

10-key proficiency

Microsoft Office

Verbal communication

Written communication

Teamwork

Prioritization

Adaptability

Education

High school diploma

Tools

Billing software

Electronic medical records

Microsoft Office

10-key proficiency

Job description

Account Follow-up Specialist

In the complex web of health care insurance and claims, you are a calm, organized problem-solver. With your advanced knowledge of the multi-payor system, you resolve delinquent payment issues. Your ability to communicate clearly, collaborate with others and maintain respect for all parties involved reflects the Legacy mission.

Responsibilities

• Resolves delinquent payment issues of complex (high dollar and specialty) accounts requiring advanced knowledge of multi-payor system.
• Investigates and evaluates patient account information, medical records and bills, billing and reimbursement regulations.
• Analyzes each account using independent judgment deciding how to best proceed with follow up to optimize reimbursement.
• Removes barriers to processing claims.
• R ebills, transfers payments, requests refunds and or adjusts misapplied payments as necessary.
• Understands and follows Legacy procedures for writing off balances and adjustments.
• Submits reconsiderations and or appeals as appropriate for denied claims.

Qualifications

Education

• High school graduate or equivalent.

Experience

• Two years of directly applicable healthcare business office experience (billing/credit/collection) required.

Skills

• Demonstrates problem-solving and decision-making skills.
• Understands complex collection issues for UB04's and CMS-1500 claims.
• Knowledge of multi-payor systems.
• Knowledge of billing/collection rules and regulations.
• Knowledge of online systems for eligibility and status review of claims.
• Familiarity with billing software and electronic medical records including Microsoft suite products and 10 key proficiency.
• Knowledge of medical terminology.
• Ability to resolve billing issues and handle denied claims.
• Ability to work efficiently with minimal supervision, exercising independent judgment within stated guidelines.
• Demonstrated effective interpersonal skills which promote cooperation and teamwork.
• Ability to withstand varying job pressures and organize/prioritize related job tasks.
• Excellent verbal and written communication skills.
• Ability to adapt to change.

Pay Range

USD $22.32 - USD $31.90 /Hr.

Our Commitment to Health and Equal Opportunity

Our Legacy is good for health for Our People, Our Patients, Our Communities, Our World. Above all, we will do the right thing.

Legacy Health is an equal opportunity employer and prohibits unlawful discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion or creed, citizenship status, sex, sexual orientation, gender identity, pregnancy, age, national origin, disability status, genetic information, veteran status, or any other characteristic protected by law.