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Follow up Specialist
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Full-time
- Follows up on outstanding payments due on all types of open medical insurance claims, i.e., managed care and commercial.
- Ensures compliance with managed care guidelines and MMC organizational policies.
- Demonstrates thorough knowledge of the electronic billing system, medical terminology, medical procedural (CPT) and diagnosis (ICD-9 CM) coding, DRGs and hospital billing claim form UB-04 is required.
- Demonstrates a thorough knowledge of contract management systems and Blue Cross and Tricare guidelines.
- Receives and researches insurance claim denials, rejections and underpayments, and as necessary, prepares the necessary paperwork to appeal the denial.
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