Global Medical Response, Inc.

Medical Insurance A/R Follow Up Specialist

Requisition ID
2021-15171
Location
US-UT-South Jordan
Employment Type
Regular Full-Time

Job Description

Our mission of providing care to the world at a moment's notice is at the heart of everything we do. We are caregivers, first and foremost, and we will be there when you need us.

With more than 38,000 employees, Global Medical Response teams deliver compassionate, quality medical care, primarily in the areas of emergency and patient relocation services around the world. We provide end-to-end medical transportation as well as fire services, integrated healthcare solutions and disaster response.

JOB SUMMARY
The Medical Insurance A/R Follow-up Specialist must have experience working with one or multiple payer sources, such as Medicare, Medicaid and Commercial insurances. The successful candidate will possess a strong attention to detail, have effective communication skills as well as a proven track record of resolving Insurance Denials and collecting on Accounts Receivable. All tasks must be performed in a timely and accurate manner in accordance with Billing Office practices, policies and procedures.

 

Pay will be based on experience, and will be discussed in your interview.


ESSENTIAL FUNCTIONS/DUTIES

  • Complete follow-up of claims on a timely basis according to the productivity guidelines for account follow-up goals
  • Meet daily and monthly departmental production goals set forth by the supervisor to ensure that the company is achieving its financial goals
  • Review and analyze claim denials in order to perform the appropriate appeals necessary for reimbursement
  • Submit appeals with supporting documentation according to the payer-specific denial reasons and procedures
  • Proactively work with the supervisor to develop appeal strategies where challenges arise
  • Identify, document and communicate trends in recurring denials. Recommend process improvements or system edits to eliminate future denials
  • Pursue unpaid accounts by telephone or electronic inquiry to determine status of payment in accordance with department follow-up time lines
  • Provide feedback to management regarding any patterns of payer denials or repetitive insurance verification, coding or billing errors that may be encountered during A/R follow-up
  • Review system generated work list and aged reports to resolve accounts which have not been paid in the appropriate time frame, based on payer contracts and guidelines
  • Review payment denials and discrepancies identified through EOB, remittance advices or payer correspondence and take appropriate action to correct these accounts
  • Comprehensively document all account activity in an accurate and timely manner for all touches made ion any patient account
  • Make inquiries via telephone, mail and fax or electronically through payer websites or e-mail for follow-up of those unresolved accounts
  • Contact patient for additional information when necessary to push the claim through for payment
  • Resubmit claims to payers as necessary via electronic, fax or hard copy
  • Other duties as assigned

 

QUALIFICATIONS

  • 1+ years of experience collecting Accounts Receivable from Insurance, Medicare or Medicaid in the medical provider industry
  • High school education; prefer some college or specialty training in medical billing or equivalent job relevant experience

 

DEMONSTRATED JOB-RELATED SKILLS/COMPETENCIES

The successful candidate will be able to work independently and in a fast paced team environment, have the experience to operate multiple computer applications, have strong experience with Microsoft Word and Excel, be able to communicate verbally and in writing, and perform at a high quality in a high volume setting. Most importantly, he or she must possess the skills to accurately analyze and research complex patient accounts, thus leading to the appropriate actions to resolve the account in a professional manner.

 

PHYSICAL/MENTAL REQUIREMENTS AND WORKING CONDITIONS

  • Regularly required to reach with hands and arms; speak and hear
  • Frequently required to sit for long periods of time
  • Occasionally required to stand and walk
  • Talk/hear - must be able to communicate, detect, converse with, convey, express oneself, exchange and process information independently
  • Adequate concentration/memory skills
  • Ability to comprehend and understand information
  • Ability to take constructive feedback
  • Meet project deadlines
  • Interpersonal communication skills
  • Ability to apply good judgment
  • Decision making
  • Ability to take direction

 

GUIDING VALUES AND BEHAVIORS

Employee must consistently exhibit our guiding principles:

  • Patient Care - We continually earn the privilege to care for our patients. It is at the forefront of everything we do.
  • One Team - We respect each other and achieve together what no individual can alone.
  • Innovation - We are driven to develop solutions that inspire progress.
  • Vigilance - We will never waver in our commitment to safety and preparedness in the fulfillment of our duties.
  • Ownership - We are accountable for what we do and take pride in how we do it.
  • Citizenship - We are dedicated to being good stewards in the communities we serve.

EEO Statement

Global Medical Response is an equal opportunity employer and as such, affirms in policy and practice to recruit, hire, train and promote, in all job classifications without regard to race, color, religion, gender, age, sexual orientation, gender identity, national origin, disability status or status as a protected veteran. Reasonable accommodation will be provided for qualified individuals with disabilities and disabled veterans in job application procedures.

 

This document in no way constitutes a contract of employment.  This description is not intended to be an exhaustive listing of all skills, duties, or responsibilities associated with the job.  Management reserves the right to revise the job, or to require that other or different tasks be performed, should circumstances change (i.e., changes in personnel, workload, or technological development)

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