Ossie Johnson

•Primary point of contact for ADP's Comprehensive Human Resources clients

•Take the initiative to seek answers, solutions, and positive outcomes for both the client and

ADP.

•Proactively initiate regular outbound communication to identify problems and offer solutions to

improve the internal operation and administration of human resources and labor policies,

practices, and procedures within the scope of our offering.

•Leverage your ADP product and services knowledge to solve issues and questions that help

clients understand our products' value.

•Partner with the assigned Resource Manager, Payroll, Benefits Solution Specialists, and third-

party vendors (as applicable) to provide troubleshooting support and a seamless client

experience.

•Carry the weight of ADP's service reputation and client satisfaction.

• A Follow-Up Specialist resolves health insurance claims on behalf of hospital or

physician clients.

• They ensure proper submission and adjudication of all claims submitted to third-party

carriers and work within the deadlines and protocols of the hospitals served.

• The individual in this role is responsible for providing a timely response to all billing

releases and inquiries in accordance with the policies and procedures of the hospital

revenue cycle they are assigned within

• This role will be responsible for knowledge in billing regarding technical billing and

basics on physician billing

• They will submit changes that are permitted by law, hospital SOP’s and stay current on

changing billing practices that will occur annually

• Review technical billing (UB04) and professional billing (1500) components provided by

Client Hospital for accuracy.

• Maintains account integrity by documenting account activities to ensure audit trail.

• Verify eligibility/coverage with health insurance carriers.

• Communicate with health insurers regarding pending claims and any unpaid balances

Associates work as part of a Team of Experts to astound customers with the effective

resolution, proactive account management, and customer education.

• This role is a learning role, where new associates are building skills and competencies in

these areas while also demonstrating world-class skills in courtesy, concern, timely

resolution, value creation, and relationship building.

• Provides astounding customer service through effective and timely resolution of various

customer inquiries and concerns.

• Uses resource documentation for reference and the automated and training tools provided

to deliver exceptional customer service.

• Appropriately disburses adjustments and account credits in accordance with T-Mobile

policy.

• Learn new skills and processes, grow knowledge of systems, and develop proficiency on

company values, organizational requirements, and competencies needed for the Expert Role.

• Knowledge of HIPPA

• Maintain accuracy of follow-up at 95% per audit guidelines

• Seek first-time resolution on each claim.

• Identify root cause of claim denials and underpayments; process appeals in accordance

with carrier policies.

• Identify denial, underpayment, or other unpaid claim trends or patterns; report such

trends and patterns to the Billing Coordinator.

• Perform balance and pending patient transfers and other related tasks.

• Document notes in the billing system in accordance with protocols; ensure adequate

detail and clarity of notes.

• Responds efficiently and effectively to customer inquiries.

• Responds efficiently and effectively to customer inquiries

• Provides accurate information to patients regarding bills

• Keeps all financial discussions with patients confidential

• Execute follow-up on claims per Medac and carrier protocols

• Maintain production of at least 45 claims daily for Anesthesia claims, 40 claims per day

for Pain claims

• Maintain accuracy of follow-up at 95% per audit guidelines

• Seek first-time resolution on each claim

• Identify root cause of claim denials and underpayments; process appeals in accordance

with carrier policies

• Identify denial, underpayment, or other unpaid claim trends or patterns; report such

trends and patterns to the Billing Coordinator.

• Perform balance and pending patient transfers and other related tasks

• Document notes in the billing system in accordance with protocols; ensure adequate

detail and clarity of notes