Accounts Receivable Specialist/Insurance Follow Up - Full Time

ThedaCare - Neenah, WI

Full-time

Neenah, WI

Ambulatory Health Care Services

About the position

The Accounts Receivable Specialist at ThedaCare plays a crucial role in the financial operations of the healthcare system by managing the billing process and ensuring timely payment for services rendered. This position is responsible for submitting billing to the appropriate parties and following up on individual claims to ensure adjudication and payment. The specialist will communicate with insurance companies, patients, guarantors, family members, and other medical staff to manage accounts receivable effectively. The role requires a proactive approach to problem-solving and a commitment to maintaining high standards of accuracy and efficiency in billing processes. Key responsibilities include performing comparative analyses to verify the accuracy of bills before submission, processing claims in accordance with contracts and regulations, and generating follow-up calls to check the status of unprocessed, unpaid, or rejected claims. The specialist will also handle various correspondence from all parties involved, ensuring that claims payments are expedited. Additionally, the role involves verifying insurance and patient demographic information, updating patient records, and reviewing internal and external reports for claims status. The ideal candidate will be detail-oriented, possess strong communication skills, and be able to work collaboratively within a team environment. At ThedaCare, we are committed to providing our team members with opportunities for continued learning and development, as well as a supportive work environment that values work/life balance. We believe in empowering our employees to be catalysts for change in the healthcare system, and we encourage those who share our vision to apply for this position.

Responsibilities

• Submit billing to the appropriate party and follow up for adjudication and payment of individual claims.
• Communicate with insurance and other payers, patients, guarantors, family members, and/or other medical staff for status of individual claims.
• Perform comparative analysis for accuracy of bill before submission to appropriate parties.
• Process claims in a timely manner according to contracts, regulations, department standards, and form requirements.
• Generate phone calls to check status of unprocessed, unpaid, or rejected claims ensuring accurate and timely reimbursement.
• Process a variety of correspondence from all parties to expedite timely resolution of claims payment.
• Verify insurance/payer and patient demographic information for accuracy of data collected at time of registration.
• Input verification data to complete in-house claims generation of billing forms.
• Re-bill accounts when new information is received requiring account updates with appropriate demographic and third-party information.
• Update patient records to indicate changes made.
• Review internal and external reports for claims status.

Requirements

• High School diploma or GED preferred.
• Must be 18 years of age.

Benefits

• Lifestyle Engagement e.g. health coaches, relaxation rooms, health focused apps (Wonder, Ripple), mental health support.
• Access & Affordability e.g. minimal or zero copays, team member cost sharing premiums, daycare.