Job Description
The Insurance Accounts Receivable Representative's primary responsibility is to provide the highest quality of customer service and accounts receivable management to our patients by embracing the Well Care Guiding Principles. The representative will review and analyze patients' medical records in conjunction with the accounts receivables to ensure that the claims were billed correctly, and that the insurance company has the necessary information to adjudicate the claims. The representative must be well versed with the insurances and adjudication processes of their partner practices. The representative will follow the prescribed steps in the Insurance Follow-Up Process to ensure that the outstanding A/R is collected within 120 days from the aging date. The representative will accept other duties/projects as assigned by the Revenue Cycle Manager. Must be knowledgeable of HIPAA Law, and standard coding such as CPT/HCPCS.
Role and Responsibilities
- Prepare and edit medical claims for submission, both hardcopy and electronically, to various third party payors and clearing houses.
- Follow-up and collect outstanding aged trial balance reports, including but limited to oral and written communications. Analyzes and appeals difficult to collect accounts.
- Review and process the daily correspondence to correct or update inquiries from insurance carriers.
- Special projects as assigned
Qualifications and Education Requirements
- Type at least 45 WPM
- EOB Knowledge.
- Payor Contractual Agreements /Fee Schedule Knowledge.
- Computer skills required (Word, Excel, PowerPoint) basic computer knowledge
- Intermediate oral and written communication skills required
- High School Diploma or equivalent
- Strong Organizational skills
- Excellent Analytical skills
- Excellent Time management skills
- Positive and Professional attitude is expected to be maintained at all times
Experience:
- 3-5 years billing experience in a high-volume multi-specialty setting, Medicare and or Medicaid billing experience preferred.