Insurance Follow Up Rep

Overview

The Chattanooga Heart Institute offers the most comprehensive cardiac care available in this region. Founded in 1976 we now have six offices in Tennessee and one in Georgia. Our practice is made up of 29 board-certified cardiologists and four cardiothoracic surgeons. We merged with CHI Memorial Health Care System in 2011 which is part of CommonSpirit Health. CommonSpirit has more than 700 care sites across the U.S. and is committed to building healthy communities.

Responsibilities

Job Summary:

Responsible for follow up of insurance to include: claims submitted, appeal processes and inquiries; monthly accounts receivable reports to ensure timely and maximum reimbursement from assigned insurance carriers.

Essential Responsibilities:

• Field patient and insurance calls regarding patient account receivables.
• Audit patient accounts for accuracy regarding charges, payments, demographics, insurance information and filing to ensure contractual agreements are being met.
• Request adjustments, write-off, payment, refunds/recoups, and transfers when appropriate.
• Work, insurance aging reports, review claims status, patient eligibility, accuracy of account information and modify as needed to ensure proper and timely payment while maintaining A/R aging per company guidelines to maximize reimbursement.
• Submit patient claims, paper and electronic, after corrections have been made or when re-billing is needed. Create appeal letters to submit to insurance carrier for timely payments.
• Review and reply (as needed) to all insurance correspondence, including assigned carrier newsletters and guidelines as well as maintain a working knowledge or assigned carrier website.
• Maintain current knowledge of insurance guidelines through newsletters and websites.
• Assist with demographics, charge entry and capture of all hospital charges.
• Work in all areas of the department during peak times, vacations, illnesses, etc.

Qualifications

Education:

• High school diploma or equivalent; some college preferred.

Qualifications:

• Two or more years in health insurance processing; medical office preferred.