FOLLOW-UP SPECIALIST (1133)

Springfield Memorial Hospital; United States; On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

401(k) match

Health/dental/vision insurance

Annual incentive program

Paid time off

Job summary

Springfield Memorial Hospital is seeking an Account Follow-Up Specialist to pursue outstanding payments from all types of medical insurance claims. You will coordinate with external insurers to resolve balances and ensure compliance with managed care guidelines, supporting Memorial Health System's standards of safety, courtesy, quality and efficiency.

The role requires at least two years in medical billing or follow-up, strong knowledge of CPT/ICD-9-CM coding, DRGs, and UB-04 forms, and

Qualifications

• Education equivalent to graduation from high school or GED is required.
• Two+ years of account follow-up or medical billing experience required.
• Ability to independently process claims of any denomination, type, and complexity.
• Thorough knowledge of CPT/ICD-9-CM coding, DRGs and UB-04 forms.
• Knowledge of contract management systems and Blues Cross/Tricare guidelines.

Responsibilities

• Follow up on outstanding payments on open medical insurance claims.
• Coordinate activities with external insurance companies to resolve balances.
• Ensure compliance with managed care guidelines and MMC standards.
• Communicate effectively with internal and external contacts.

Skills

Billing systems

Medical terminology

CPT coding

ICD-9-CM coding

DRGs

UB-04

Contract management systems

Blue Cross/Tricare guidelines

Communication skills

Prioritization

Organization

Problem solving

Education

High school diploma or GED

Tools

Microsoft Word

Microsoft Excel

Job description

Focused on the Future of Care

We're looking for talented, passionate healthcare professionals to join the team at Memorial Health as we build the future of healthcare. If you're ready to be part of a transformative organization that puts people first, take a look at what we have to offer.

Position Type

On-site

Position Summary

Follows up on outstanding payments due on all types of open medical insurance claims, i.e., managed care and commercial. Coordinates activities with external insurance companies for the resolution of patient account balances. Ensures compliance with managed care guidelines and MMC organizational policies. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values.

Job Description

Education

Education equivalent to graduation from high school or GED is required.

Experience

Two or more years as an Account Follow-Up Specialist, or comparable years of medical insurance and/or health care billing experience is required.

Possesses the technical knowledge to independently process claims of any denomination, type, and complexity is required.

Other Knowledge/Skills/Abilities

• Demonstrates thorough knowledge of the electronic billing system, medical terminology, medical procedural (CPT) and diagnosis (ICD-9 CM) coding, DRGs and hospital billing claim form UB-04 is required.
• Demonstrates a thorough knowledge of contract management systems and Blue Cross and Tricare guidelines.
• Basic working knowledge of personal computers and their associate user software is required. Experience with Microsoft Office products Word and Excel is preferred.
• Ability to work within the guidelines of defined managed care contract policy provisions and company procedures.
• Demonstrated ability to work successfully with internal customers and external contacts is required.
• Possesses highly-developed prioritization and organization skills and critical thinking and problem solving ability.
• Demonstrates excellent communication skills, including telephone etiquette, and keyboarding and basic math skills.

Pay Transparency

$18.34 - $28.42

Additional compensation in the form(s) of participation in our annual incentive program are dependent on role. Pay is based on factors such as work experience, education, certification(s), training, skills, and competencies related to the role.

Benefits

Memorial Health also offers a comprehensive benefits plan, which includes paid time off, 401(k) match, and health/ dental/ vision insurance options.

All benefits can be found at https://jobs.memorial.health/about/benefits/

Accommodation

If you require a reasonable accommodation to complete this application or participate in the hiring process, please contact [e-mail]. Requests will be handled confidentially.