Insurance Follow-Up Specialist

Description

ABOUT US
IVX Health is a national provider of infusion and injection therapy for those with Rheumatoid Arthritis, Crohn's Disease, Multiple Sclerosis and other complex chronic conditions. IVX offers a different, better approach to caring for our patients and believes it is vital to take the same approach with our employees. We strive to empower our team to succeed while embodying our core values: Be Kind, Do What's Right, Never Settle, Make It Happen, and Enjoy the Ride.

ABOUT THE ROLE
The Insurance Follow Up Specialist is responsible for many facets of medical billing and accounts receival management, including insurance and patient follow-up in accordance with practice protocol with an emphasis on maximizing patient satisfaction and profitability. This role is also responsible for providing phone support for patients and providing feedback to manager regarding patient registration and preauthorizations.

RESPONSIBILITIES

• Ensures timely payment by identifying denial trends
• Understands how to research and work closely with insurance carriers for reimbursement requirements
• Knowledge of verification of benefits and coordination of benefit processes
• Ability to read and interpret LCD/NCD requirements in regard to CPT and HCPCS denials
• Ability to work supervisor requirements of 50 to 100 denials per day based on supervisor requirements
• Understand and work with clearinghouse and electronic claim interchange
• Work closely with front office and prior authorization team to maximize reimbursement
• Work as a team player in order to meet department goals
• Take incoming calls from insurance carriers, patients and other departments
• Have a vast understanding of the claim life cycle
• Become familiar quickly with all duties and perform them accurately, independently, promptly, efficiently while recognizing their importance and relationship to patient care
• Ensure all deadlines for processing and reporting are achieved consistently

Qualifications

ESSENTIAL COMPETENCIES

• Strong analysis and analytical skills
• Advanced knowledge of regulatory and compliance regulations
• Comprehensive understanding of fee schedules, payor policies and managed care contracts, including Medicare and Medicaid
• Working knowledge of Medicare compliance, OSHA, and HIPAA.
• Familiarity with NaviNet and Availity, as well as payer portals.
• Strong working knowledge of ICD-10, CPT, HCPCS, referrals and pre-certification procedures, as well as documentation guidelines
• Proficiency with standard office software applications (Microsoft Office, Outlook, Teams, etc.)

REQUIRED EDUCATION & EXPERIENCE

• High school diploma or GED required
• Minimum of five (5) years billing experience in a healthcare setting

PAY RANGE
Pay is based on a number of factors including market location, job-related knowledge, skills, and experience and is benchmarked against similar organizations to our size and industry. For our Insurance Follow-Up Specialist role, we generally pay new hires between 20.14 and 22.42 per hour. It is not typical for an individual to be hired at or near the top of the range for roles and compensation decisions are dependent on the facts and circumstances of each situation. In addition to cash pay, full-time regular positions are eligible for 401(k), health benefits, and other company benefits; some of these benefits may also be available for part-time positions.

EEO STATEMENT
IVX Health is proud to be an Equal Opportunity Employer. We value diversity and are committed to creating an inclusive environment for all employees. IVX Health wants to have the best available people in every job, and we make employment decisions on the basis of business needs, job requirements, individual qualifications, and merit. Equal employment opportunities are provided to all employees and applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, pregnancy, national origin, military and veteran status, age, physical or mental disability, genetic characteristic, reproductive health decisions, family or parental status, or any other legally protected category in accordance with applicable federal, state, or local laws. IVX Health prohibits discrimination, harassment, or retaliation of any kind based on any of these characteristics. Equal employment opportunity will be extended to all persons in all aspects of the employer-employee relationship and all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation benefits, and separation of employment.