Account Follow-up Specialist II at Legacy Health – PORTLAND, Oregon

Legacy Health

Account Follow-up Specialist II

Equal Opportunity Employer/Vet/Disabled
US-OR-PORTLAND

Job ID: 25-46099
Type: Supplemental
Northwest 31st Bldg

Overview

In the complex web of health care insurance and claims, you are a calm, organized problem-solver. With your advanced knowledge of the multi-payor system, you resolve delinquent payment issues. Your ability to communicate clearly, collaborate with others and maintain respect for all parties involved reflects the Legacy mission.

If this sounds like you, we invite you to apply for our Account Follow-up Specialist role.

Responsibilities

• Resolves delinquent payment issues of complex (high dollar and specialty) accounts requiring advanced knowledge of multi-payor system.
• Investigates and evaluates patient account information, medical records and bills, billing and reimbursement regulations.
• Analyzes each account using independent judgment deciding how to best proceed with follow up to optimize reimbursement.
• Removes barriers to processing claims.
• Rebills, transfers payments, requests refunds and or adjusts misapplied payments as necessary.
• Understands and follows Legacy procedures for writing off balances and adjustments.
• Submits reconsiderations and or appeals as appropriate for denied claims.

Qualifications

Education:

• High school graduate or equivalent.

Experience:

• Two years of directly applicable healthcare business office experience (billing/credit/collection) required.

Skills:

• Demonstrates problem-solving and decision-making skills.
• Understands complex collection issues for UB04’s and CMS-1500 claims.
• Knowledge of multi-payor systems.
• Knowledge of billing/collection rules and regulations.
• Knowledge of online systems for eligibility and status review of claims.
• Familiarity with billing software and electronic medical records including Microsoft suite products and 10 key proficiency.
• Knowledge of medical terminology.
• Ability to resolve billing issues and handle denied claims.
• Ability to work efficiently with minimal supervision, exercising independent judgment within stated guidelines.
• Demonstrated effective interpersonal skills which promote cooperation and teamwork.
• Ability to withstand varying job pressures and organize/prioritize related job tasks.
• Excellent verbal and written communication skills.
• Ability to adapt to change.