No experience
Employment Type:
Full time
Job Category:
Customer Service
Insurance Follow-up and Collection Representative
(This job is no longer available)
Bayhealth | Dover, DE
Grad Date

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Job Description

Job Details

High School/GED

The Insurance Follow-Up and Collections Representative is responsible for the follow up on all hospital and/or professional insurance claims. The position requires entry level knowledge of all payer and claim types and the ability to prioritize work flow to meet insurance company filing deadlines for claim submission, claim reconsiderations and appeals and achieve targeted receivables on a monthly basis and expedite cash flow. Specific duties involve researching unpaid claims, responding to insurance company information requests, submitting reconsiderations for partially paid claims, appealing denied claims and resolving payment variances as encountered to facilitate timely patient billing.

Minimum Education and Experience:




High School diploma or GED

1 year of college or technical school coursework


One year experience in medical billing and collections, medical bad debt collections or intern/externship of medical billing experience related to a certification program.

One year hospital billing or collections experience.

Computer/Software Knowledge:

Experience with medical billing and claims editing systems.

Intermediate experience with Microsoft Word and Excel.

Experience with Epic and xClaim.


Special Knowledge, Skills, and/or Abilities:

* Performs all areas of job functions at a high accuracy rate.
* Knowledge of revenue-cycle, managed care environment, 3rd party reimbursement, and hospital financial resources.
* Position requires basic knowledge of applicable Federal, State and commercial insurance regulations, insurance plans, member eligibility and medical billing and collections.
* Understanding medical billing claim forms.
* Exceptional written, verbal and interpersonal communication skills; must demonstrate ability to articulate information in a clear and informative manner.
* Ability to read and interpret documents such as an Explanation of Benefits and/or Remittance Advice and properly identify denials and patient responsibility amounts from remittances required
* Detail oriented, strong problem solving and analytical skills.
* Ability to multitask and use multiple windows/programs at one time.
* Must be proficient in reading, writing, and speaking English.
* Bilingual preferred.

About Bayhealth

Bayhealth's cardiac program also offers diagnostic cardiac catheterization, cardiopulmonary rehabilitation, cardiac care for patients recovering from heart attacks, nutritional counseling, and "Lifestyles Fitness Centers" for ongoing rehabilitation. All pre-surgical and post-surgical services, like the surgeries themselves, occur right here at Kent General Hospital, eliminating long-distance travel time for patients and their families. Patients no longer have to travel to Salisbury or Wilmington for cardiac surgery and interventional cardiology. The University of Pennsylvania Health System is home to the Hospital of the University of Pennsylvania, one of the nation's recognized leaders in cardiac surgical innovation and expertise. In 2005, for the ninth consecutive year, the Hospital of the University of Pennsylvania (HUP) was ranked as one of the nation's "Honor Roll" hospitals by U.S. News & World Report in its annual ranking of "Best Hospitals" in America. In that same issue, Penn's was also ranked #20 in "Heart and Heart Surgery." In the May 2003 issue of Philadelphia magazine, Penn Cardiac Care was identified as one of 36 Penn-based "Centers of Excellence" for its expertise in comprehensive cardiac care, including cardiac surgery. Since September 2003, UPHS and Bayhealth have worked together to plan policies and procedures, set up systems for the new program, and recruit and train staff. Now, Bayhealth will operate the administratively independent cardiac surgery program with access to UPHS for specialty procedures and support.