Accounts Receivable Representative III

Job Description:

• Coordinates, monitors, and manages the follow-up on unpaid claims
• Ensures follow-up and reimbursement appeals of unpaid and inappropriately paid claims
• Identifies, researches, and ensures timely processing of billing errors and corrections as they relate to claims
• Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties
• Ability to communicate and collaborate effectively with other internal as well as external resources to achieve desired results and resolve issues
• Review and work all daily correspondence
• Appeals denied claims via mail, telephone, or websites
• Perform audits on accounts when needed to review for accuracy
• Update accounts with information obtained through correspondence and telephone
• When necessary, contacts patients, referring providers or a hospital to obtain better insurance information, authorization, or updated patient demographics to assist with collections
• Completes appropriate account maintenance by ensuring that the correct statement groups, financial class, and payer codes
• Accurately documents all follow up on the account to ensure there is an accurate record of the steps taken to collect on an account
• Pitches in to help the completion of the daily AR Representative 2 workload to support AR team productivity and outcome measures
• Meets the current productivity standard which include both quantity and quality metrics
• Maintains a working knowledge and understanding of CPT and ICD-10 codes
• Keeps current with health care practices and laws and regulations related to claims collections
• Performs other job-related duties within the job scope as requested by Management

Requirements:

• High school diploma or equivalent certification required
• Associate degree or equivalent from a two-year college preferred; or equivalent combination of education & experience
• 3 to 5 years of health care claims reimbursement and denial resolution experience
• Knowledge of Major Commercial (Aetna, BCBS, Cigna, UHC) as well as Medicare/Medicaid payer guidelines
• Strong computer skills (including MS Word and Excel)
• Ability to maintain accuracy while working on multiple tasks in a fast-paced environment under low-to moderate supervision
• Excellent verbal and written communication skills, including professional telephone etiquette
• Ability to ensure confidentiality of sensitive information and maintain HIPAA compliance
• Dependable in both production and attendance
• Exceptional organization and time management skills

Benefits:

• Paid Time Off
• Health, life, vision, dental, disability, and AD&D insurance
• Flexible Spending Accounts/Health Savings Accounts
• 401(k)
• Leadership and professional development opportunities

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