Follow-up Specialist

Boys Town
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Schedule: Full time days, 8:00am – 5:00pm; Monday to Friday

Location: Central Billing Office - 42nd St. and Center St.

Job Summary:

In a career at Boys Town National Research Hospital, you join us in changing the way America cares for children and families.  We are currently expanding services.  Come grow with us!


  • Under the direction of the Insurance Follow up Supervisor, is responsible for reducing and managing the A/R by reviewing and resolving unpaid claims related to clinical/facility charges.

  • Works assigned payer denials and claims not responded to in order to ensure proper handling and maintain appropriate follow through workflows for claim resolution. When necessary, uses creative approaches and information gathered from contacting payers when new denials are presented to seek reimbursement. Determines reasons for denials and recommends the appropriate action to prevent future denials when possible.

  • Determines and processes account adjustment transactions in accordance with department procedures. Completes transactions using the appropriate adjustment code allowing for account level and reporting integrity.

  • Identifies and works with department members and management to resolve coding, billing, denial, and reimbursement trends along with identifying other revenue cycle problems.

  • Maintains up to date knowledge of BTNRH payer contracts/fee schedules to fully understand correctness of payer response and allowances received on remittance advices.

  • Maintains an in-depth understanding and expertise of assigned payer(s) billing requirements, including 837 I and 837 P loops and segments according to 5010 rules, to ensure timely and accurate response/payment, is received from third party payers.

  • Maintains current knowledge of all HCFA 1500 & UB-04 electronic and paper claim elements and requirements, insurance ANSII codes and relating BTNRH registration processes that affect the accuracy of billing.

  • Achieves or exceed goals and objectives set for position and/or department, maintaining productivity and quality standards, while formulating an action plan when necessary to improve personal performance.

  • Other Duties: This job description incorporates the essential functions and duties required for this position. However, other duties may be required and assigned at times and as determined by a supervisor in order to meet the needs of the organization.

  • Knowledge, Skills and Abilities Required:

Ability to apply moderate analytic skills to review data and trends, as well as to organize workload according to established priorities.

Ability to maintain a positive, friendly and professional attitude at all times with patients, as well as internal and external customers.

Ability to perform arithmetic calculations and be familiar with the use of Microsoft Office Applications (Excel, Word, Outlook, etc.) while typing consistently at a minimum of 40 wpm.

Ability to treat all information gained with strict confidentiality.

Ability to operate standard office machines and equipment such as a multi-line telephone, calculator, photocopier, desktop computer.

Ability to communicate concisely, both orally and in writing, with a wide variety of people, to include managers and coordinators.

Ability to work independently with limited supervision, as well as to function as a team player, taking initiative and demonstrating the highest professional and ethical standards to represent the Patient Financial Services department.

Working knowledge of health care coding systems (procedural, diagnosis, modifier, remittance and others).

Understanding and ability to utilize various electronic, web based and manual coding and payer resources.

General understanding and knowledge of Center for Medicare and Medicaid Systems (CMS) billing and coding requirements and compliance expectations.

Working knowledge of government and commercial health plan insurer coverage, claim requirements and remittance processing.

Required Qualifications:

  • Minimum of one year experience in a medical billing environment, preferred.

  • Understanding of office procedures (problem solving and making recommendations) and prior proficient use of a personal computer to include Microsoft Office applications (Outlook, Word, Excel).

  • Working knowledge of third party payer reimbursement guidelines (CPT, HCPC and ICD-9 & ICD-10 coding) and HCFA 1500 & UB04 billing, and their application to services rendered.

  • Excellent telephone skills and typing speed minimum of 40 wpm.

Boys Town National Research Hospital:

Boys Town National Research Hospital offers a broad range of hospital and clinic services, backed by 40 years of life-changing research to provide the latest, most innovative care to our patients.  From pediatric inpatient hospitalization and surgical services, to outpatient visits, to residential care for children and adolescents with severe behavioral disorders, our board certified specialists and highly trained pediatric nurses’ focus on caring for the unique needs of children and their families.  Boys Town National Research Hospital is a license acute care hospital and psychiatric residential treatment facility and accredited by The Joint Commission.  Boys Town National Research Hospital is part of Boys Town, which has been committed to the care of children for over 100 years.

Our employees are our #1 supporters when it comes to achieving Boys Town’s mission, which is why we offer an array of competitive and attractive benefit options.  Unique perks to Boys Town employees and their families include free visits to Boys Town Physicians, free prescriptions, tuition assistance, access to the campus Field House, parenting resources from our expects and advancement opportunities within the organization, just to name a few.  Working at Boys Town is more than just a job; it is a way of life.

Date Posted: January 29, 2020

Job ID: 15058

This advertisement describes the general nature of work to be performed and does not include an exhaustive list of all duties, skills, or abilities required. Boys Town is an equal employment opportunity employer and participates in the E-Verify program. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.  To request a disability-related accommodation in the application process, contact us at 1-877-639-6003.

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Omaha , United States