The Accounts Receivable Representative is responsible for the follow-up and collections of all open accounts and ensures prompt and accurate reimbursement. This position initiates outgoing telephone calls and responds to incoming telephone and in-person inquiries from insurance companies, patients, patients’ families and faculty practice staff regarding collection of payments and delinquent accounts.
Reduces accounts receivable by following up on unpaid claims with third party payors, 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 requirements, diagnosis and procedure coding, and applicable county, state, and federal requirements.
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.
Establishes payment arrangements according to pre-set guidelines; documents terms in ETM.
Incumbent will be responsible for all ETM edit requests categories from write offs, appeals, authorizations, charge entry, coding, front end issues, medical records, payment posting, and underpayments.
High school graduate or GED certificate.
Good interpersonal, verbal, telephone and written communication skills in the English language.
Functional knowledge of basic computer operation and keyboard functions.
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.
Minimum of 6 months to one year experience in a physician billing or third party payor environment.
Computer software skills: Knowledge of and proficiency with GE/ETM (IDX), Microsoft Word, Excel
Medical terminology experience.
Knowledge of contracts, insurance billing requirements and CMS 1500 claim forms, worker’s compensation, HMOs, PPOs, capitation, Medicare, Medicaid and compliance program regulations.