Healthcare Accounts Receivable Rep.
Overview
The Accounts Receivable Representative is responsible for follow up of outstanding A/R and resolution of denials for various payers. As such, the responsibilities include effective research and resolution of AR work queues and handling of all insurance related correspondence or patient accounts is required to maximize reimbursements.
Responsibilities
In this role, you will:
• Ensure the coordination of invoice activities leading to timely reimbursement of receivables using available resources including databases, internet, and telephone.
• Research and resolve denials received that have not passed payer edits and may lead to a final appeal of denied services. Requires knowledge of a variety of system applications both internal and external. Determines and initiates action to resolve rejected invoices, prepares payer corrections, and/or appeals using electronic and paper processes.
• Provide guidance, assistance, education, and communications with internal and external customers related to insurance and government payers claims processing protocols.
• Utilize various resources to determine patient’s eligibility, benefits, and health plan confirmation. Including online payer databases, CareCentrix Eligibility platforms, and medical records that may result in provider or payer recoup/rejection activity.
• Oversee accounts receivable adjustments to resolve overpayments and payment rejections according to standard operating procedures. Analyze and clears payment variances. May prepare adjusted and corrected claims/invoices or adjust accounts receivable entries in accordance with existing operating procedures. May include the use of special reporting.
• Evaluate, analyze and monitor the processing of invoices and on-line notes, utilizing a Windows based data processing system. Monitors payer responses, using Microsoft Excel, Microsoft Access and other software as necessary to ensure prompt payment.
• Contact providers and/or patients to retrieve appropriate medical documentation to substantiate services provided and engage them in assisting CareCentrix in collecting for the payer.
• Provide payers with detailed itemization of services performed to ensure timely reimbursement. Review EOPs/EOMBs/EOBs for accuracy of patient responsibility.
• Provide input on accounts receivable process improvements and assisting in their implementation.
• Participate in teleconferences covering a wide range of topics that enables the Revenue Cycle Management division to effectively collect account receivables.
• Works with internal customers to identify issues which may result in updated processes/workflows and new enhancements or platforms as necessary.
• Maintain departmental quality standards to maximize CareCentrix health plan collections and account resolution. Participates in special projects and performs other duties as assigned.
Qualifications
You should reach out if you have:
- High School Diploma or equivalent; plus minimum of 1 years of experience in Revenue Cycle Management Operations, preferably in the medical, insurance or healthcare field generally required.
- Knowledge of healthcare collection procedures and related internal and external software applications are required.
- Effective analytical, verbal and written communication skills are required as well as knowledge of HIPAA, HCPCS, CPT, ICD-9 & ICD-10 coding.
- Basic competency of Microsoft office applications and mathematical calculations is required.
- Must be well organized and possess excellent time management skills.
What we offer:
- Salary Range: $16.35 – $20.00 / hour plus bonus incentive.
- Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match.
- Generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more.
- Advancement opportunities, professional skills training, and tuition Reimbursement
- Great culture with a sense of community.
CareCentrix maintains a drug-free workplace.