The ideal candidate will have experience with insurance follow-up.

Overview

Under general supervision, this position supports the vision and mission for the University of Maryland Medical Systems, a multi-billion dollar, regional healthcare facility. Expectations include, but are not limited to, Insurance verification, evaluating financial responsibility of patients, updating accounts to a billable/collectible status, researching denials, claim rejections, and delays in reimbursement, utilizing all possible means to resolve accounts, which include contacting patients, insurance companies and other departments. Assists the department by organizing collection procedures and meeting performance goals while adhering to current laws and payer regulations and reducing uncompensated care.

Key Responsibilities

Works and maintains assigned receivables through work queues, age trail balance reports (ATB's), and special projects to achieve established department goals through resolution of outstanding account balances and reduction of uncompensated care.

• Works with third party insurances to obtain maximum level of cash to reduce receivable.
• Reviews financial references, including guidelines for reimbursement, state and federal regulations, payer-specific reimbursement policies, procedures.
• Ensures correct processing of outstanding insurance claims by: interpreting insurance payer responses, requesting account level adjustments, submitting appeals and claims reconsiderations, evaluating financial responsibility of patients, resolving insurance denials and claim rejections, performing insurance verification.