Conducts timely follow-up on patient accounts billed to insurance companies to determine reasons for delayed or missing payments.
Investigates denied or rejected claims, reviews insurance remittance advice, and identifies reasons for denial.
Collaborates with insurance carriers, internal billing teams, and other stakeholders to obtain necessary information and documentation to resolve claims.
Documents findings and actions taken to resolve denials or delays in payment.
Initiates and manages appeals or resubmissions of denied claims as appropriate.
Communicates effectively, verbally and in writing, directly with payors to follow up on outstanding claims, files technical and clinical appeals. Resolves payment delays/non-payments to ensure timely and accurate reimbursement.
Maintains accurate records of follow-up activities and payment status in the billing system.
Identifies trends in denied claims and recommends process improvements to reduce denials and expedite payment.
Provides excellent customer service to patients and internal teams regarding billing inquiries and insurance follow-up.
Common Expectations:
Maintains appropriate records, reports, and files as required.
Maintains established policies and procedures, objectives, quality assessment, safety, environmental and infection control standards.
Participates in educational programs and in-service meetings.
Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.
Required for All Jobs:
Performs other related duties as identified.
WellSpan Health has adopted and implemented a compliance program to support WellSpan's values and standards for professionalism, integrity, and ethics. Expected to support and meet the values and standards of the organization and the performance expectations of the job, the department, and the compliance program.
WellSpan Health has adopted and implemented a privacy program to safeguard the patient information and the business and operational information of the organization. Expected to support and meet the values and standards of the organization to safeguard patient and business/operational information.
The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.
Physical Demands:
Standing - Occasionally
Walking - Occasionally
Sitting - Frequently
Reaching - Rarely
Talking - Frequently
Hearing - Frequently
Repetitive Motions - Occasionally
Eye/Hand/Foot Coordination - Occasionally
Benefits Offered:
Comprehensive health benefits
Retirement savings plan
Paid time off (PTO)
Education assistance
Financial education and support, including DailyPay
Expanded Paid Parental Leave
For additional details: Benefits & Incentives | WellSpan Careers (joinwellspan.org)