The Lead Accounts Receivable Representative is responsible for the follow-up and collections of all open accounts and ensures prompt and accurate reimbursement. In addition to maintaining standard productivity levels the lead revenue cycle representative works closely with the supervisor on assigned tasks.
Reduces accounts receivable by following up on unpaid claims with third party payers, patients, or other responsible parties. Investigates assigned accounts to determine what additional steps must be taken for claims to be paid.
Maintains a thorough working knowledge of all aspects of billing and collections including billing rules and regulations, collection practices, electronic billing processes, CMS 1500 Form requirements, diagnosis and procedure coding, and applicable county, state, and federal requirements.
Researches and responds to insurance and patient requests. Addresses incoming correspondence and prepares correspondence to insurance companies, patient and/or guarantor, as necessary.
Assists with claim issues, including accounts that are delinquent, initiates appropriate action and maintains records.
Contacts insurance companies and/or patient/guarantor through direct contact, letter, or other means of due diligence. Update the on-line system with accurate and complete information.
Assists in eligibility and works with the insurance company, patients and/or families in resolving charging and billing problems. Reviews account history for third party sponsorship.
Establishes payment arrangements according to pre-set guidelines; documents terms in ETM(IDX).
Minimum of two (2) years experience in a physician billing or third party payer environment.
Knowledge of contracts, insurance billing requirements and CMS 1500 claim forms, worker’s compensation, HMOs, PPOs, Medicare, Medicaid and compliance program regulations.
Good interpersonal, verbal, telephone and written communication skills in the English language.
Functional knowledge of basic computer operation and keyboard functions.
High school graduate or GED certificate.
Ability to follow-through and handle multiple tasks simultaneously.
Ability to work independently.
Some knowledge of electronic billing systems.
Must be a motivated individual with a positive attitude and exceptional work ethic.