Denials & Follow-up Representative - Professional Partnerships

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⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

⏰ Full Time

🟢 Junior

💰 Account Manager

🚫👨‍🎓 No degree required

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Ochsner Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1942

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

💰 Grant on 2023-07

Healthcare • Healthcare Insurance • Non-profit

Ochsner Health is a comprehensive healthcare system dedicated to delivering health services to the people of Louisiana, Mississippi, and the Gulf South. Its mission is to serve, heal, lead, educate, and innovate in healthcare. As the largest academic medical center in Louisiana, Ochsner focuses on a clinically-integrated research program aimed at improving community wellness and educating future healthcare leaders. They offer a variety of services, including primary care, urgent care, women's and men's health, digital medicine, and specialized treatments such as cancer care, heart and vascular services, transplants, and more. Ochsner also emphasizes community engagement through partnerships, education, and outreach programs, while fostering an inclusive environment. They are committed to accessibility, patient stories, and transparency in billing and insurance information. Ochsner is a non-profit organization and an equal opportunity employer.

📋 Description

• Resolve outstanding insurance account receivables. • Perform collection and billing activities related to account resolution. • Communicate with Government and Commercial payors, clients, reimbursement vendors, and patients. • Research accounts using internal and external resources, phone, and payor websites to determine account status and obtain payment. • Verify and update insurance and demographic information to resolve payment barriers. • Follow up with payors and check claim status throughout the payment process. • Appeal denials and determine when appeals require further research or review. • Maintain knowledge of differing payor guidelines to ensure accurate reimbursement. • Identify trends causing account issues and report recommendations for system improvements or edits. • Remain knowledgeable about applicable laws, accreditation standards, and regulatory requirements and ensure compliance. • Report known or suspected unethical conduct and patient, employee safety, privacy, or compliance concerns.

🎯 Requirements

• High School diploma or equivalent required • 1 year related experience in a hospital, clinic, medical office, business services/revenue cycle, front-line registration, financial counseling, banking, or customer service role • Computer skills and dexterity for data entry and retrieval • Effective verbal and written communication skills • Proficiency with Windows-style applications, keyboard, and role-specific software packages • Strong interpersonal skills • Ability to multitask • Ability to perform effectively in a fast-paced, ever-changing environment • Ability to remain calm and professional in high-pressure or stressful patient financial and medical conversations • Reliable transportation to travel to other facilities to fill in as needed • Prior experience with EPIC system preferred • Associate's degree or bachelor's degree preferred • Ability to comply with applicable laws, accreditation standards, and regulatory requirements

🏖️ Benefits

• Remote work arrangement • Reasonable accommodations for qualified individuals with disabilities • Equal opportunity employment • Accessibility and application-process accommodation support