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Insurance Follow-up Representative - Healthcare 2729736 A leading medical institution is seeking an Insurance Follow-up Representative - Healthcare. The successful candidate will be responsible for billing and follow-up of government, commercial, contract, and/or managed care accounts receivables and resolve all outstanding insurance accounts through constant communication with the payers (by phone or via web access), different units, clinical departments, and billing agents. The ideal candidate has one or more years of previous insurance follow-up experience. Insurance Follow-up Representative - Healthcare Pay and Benefits: * Hourly pay: $35/hr * Worksite: Leading medical institution ( Emeryville, CA 94608 - Hybrid, must be onsite at least 3 days/week for training, then onsite once a month, Must orient and work at all Medical Center locations) * W2 Employment, Group Medical, Dental, Vision, Life, Retirement Savings Program, PSL * 40 hours/week, 6 Month Assignment Insurance Follow-up Representative - Healthcare Responsibilities: * Examine and evaluate accounts for appropriate follow-up action consistent with guidelines and documentation protocols prescribed. * Make daily inquiries on unresolved invoices by phone or via the Internet. * Interpret account information and enter important details to provide an audit trail for further follow-up. * Research missing payments by reviewing EOB (Explanation of Benefits), APEX, and RMS. * Review of non-payment and/or incorrect payment for possible appeal. * Analyze Explanation of Benefits (EOBs) for accurate posting of rejection, adjustment and other posting requirements needed in APEX. * Adheres to the rules and regulations of the different types of payers. * Initiate charge correction request. * Other Follow Up Duties May include: * Secure guarantor/patient demographic and /or insurance information as required. * Process correspondence as required in accordance with departmental procedures. * Billing or rebilling corrected claims. * Create the orthopedic DME (Durable Medical Equipment) Invoice form. Insurance Follow-up Representative - Healthcare Qualifications: * 1+ year of previous insurance follow-up experience. * Associate or Bachelor's Degree is preferred. * High School Graduate or GED equivalency. * Certified Procedural Coder (CPC) is preferred. * Epic resolute professional billing experience. * Experience in medical billing, with a preference for Professional Fee (ProFee) billing. * Experience with government Professional Fee (ProFee) billing. * Insurance claims follow-up experience/denial management experience. * Working knowledge of the EPIC (Apex) system, especially PB or HB Insurance Follow-up Module(s) is preferred. * Experience with MS EXCEL and OUTLOOK. * Familiarity with payer websites and payer-provider services. * Knowledge of Medi-Cal managed care processes is preferred. * Ability to communicate effectively (orally and written). * Knowledge of CPT and ICD-10. * Effective Time Management and ability to meet deadlines. * Ability to work independently or as needed with a team and meet productivity and quality standards. * Positive attitude and excellent customer service skills. * Proven ability to coach and mentor staff for optimal results. * Ability to set priorities, goals, and objectives. * Ability to perform all aspects of billing and follow-up with superior quality. * Knowledge of various systems including, but not limited to: Microsoft Word, EXCEL, Outlook, APEX, Payor Web Portals, Health Logic, government and/or non-government websites, and any other information systems that would be required for insurance eligibility, benefit verification or other information needed during detailed follow-up. Insurance Follow-up Representative - Healthcare Shift: * Monday to Friday from 07:00 am to 03:30.