Catholic Health is one of Long Island’s finest health and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island.

At Catholic Health, our primary focus is the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes – to every patient, every time.

We are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace!

The Sr. Insurance Follow-Up Representative will be responsible for assisting with the daily management of both the claims and follow up teams. The core responsibilities are to track and trend issues reported by the teams. The Sr. Representative will need to have knowledge of the claims process as well as follow up procedures. All job functions are required to be completed with a minimum number of errors and are subject to routine quality reviews.

DUTIES/RESPONSIBILITIES:

• Investigate claim status with insurance carriers, correct and resubmit denied claims
• Using electronic accesses (Insurance carrier websites, Onbase, banking websites) to troubleshoot problems identified by the team
• Learn computer applications as they relate to denial management systems
• Assist in Staff training, creating educational presentations in Power Point and job aids
• Assisting in developing and implementing new policies and procedures
• Assist in preparing for team and departmental meetings agendas and minutes
• Occasionally run team meetings or touchbases, meet with management from other teams to resolve issues
• Assist in drafting department appeal letters and appeals processes
• Preparing monthly productivity reports and spreadsheets for leadership
• Review and approve or decline adjustments requested by the team, provide monthly totals on declined adjustments and education to team members with a high percentage or errors
• Complete quarterly audits for productivity and accuracy for all team members and then present findings to the employee
• Complete monthly audits on automated adjustments, provide feedback on any errors
• Complete weekly audits of all paper claims, and provide updates to team members not following proper workflows
• Maintain various tracking documents for issues and updates that will be reviewed by management
• Sit in on employee reviews and write ups as needed
• Counsel employees struggling with productivity and provide tips and tricks
• Maintain acceptable work volume per day
• Other duties as assigned by Supervisor, Manager or Director

 POSITION REQUIREMENTS AND QUALIFICATIONS:

Education:

High School diploma or equivalent required.  

Skills:

• EPIC experience required
• 5+ years’ experience in healthcare insurance billing, knowledge of third party insurance in regards to plan types (HMO/PPO/POS and Indemnity) required
• Attention to detail – ability to maintain speed while upholding accuracy
• Knowledge of CPT, ICD-9 and basic medical terminology required
• Ability to perform analytics on issues and report on A/R trends
• Skilled in Microsoft Office products. Word, Excel, and Power Point will be used daily
• Ability to communicate clearly and effectively both verbally and written with a wide range audience
• Needs to work independently and take initiative
• Time management is a key function to being successful in this role
• Must be organized and able to multi task
• Ability to speak in front of large groups in person and on camera

Experience:

Five years of Physician Billing experience, including follow up, required.

This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate’s qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits.

At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.