Accounts Receivable Representative - Medical

Position Title: Accounts Receivable Representative - Medical

Reports To: Accounts Receivable Assistant Manager

FLSA Status: Non-Exempt

Position Type: Full-Time

Work Schedule: Monday - Friday

Direct Reports: None

Position Summary:

Secures revenue by verifying and posting payments and resolving discrepancies. Review and correct all denials for medical insurance claims. Follow-up on accounts for non-payment. Handle customer service calls. Take patient payments and post to the appropriate practice management system. Document all actions taken on each account in the practice management system.

Essential Duties and Responsibilities:

• Answer all incoming calls within three rings and assist callers with requests.
• Review patient accounts with patients and make any corrections necessary.
• Take credit card payments over the phone and post to patient’s accounts; making any appropriate adjustments, as needed.
• Review denials for all payers to determine if denials are accurate, and make corrections required.
• Process rebills for payment, or adjust denials as necessary.
• Advise Director of any trends in denials or payer issues that need to be addressed.
• Review the Accounts Receivable Reports as assigned to follow-up with payers on unpaid claims.
• Document all actions taken on any account to the appropriate practice management system.
• Provide back-up to the Attorney Liaison staff as needed for Ledger requests.
• Perform related duties as assigned by supervisor.
• Maintain compliance with all company policies and procedures.

QUALIFICATIONS

Formal Education:

• High School Diploma or equivalent.

Related Work Experience:

• Minimum of 3 years’ experience working medical charge denials and appeals for all major payers; including commercial and government medical, Workers’ Compensation and automobile accident claims.

Licenses or Certifications: N/A

Specialized Knowledge/Skills:

• Knowledge of medical billing processes and billing software.
• Working knowledge of medical invoices (industrial/special circumstance billing).
• Knowledge of medical insurance terminology such as guarantor, primary, group ID and subscriber ID.
• Excellent mathematical computation skills.
• Excellent typing (minimum 40 WPM) and computer usage skills, including Microsoft Office (Word and Excel).

Competencies:

• Customer service focus – ability to relate with people of diverse backgrounds, and provide excellent customer service and solutions to problems.
• Attention to detail.
• Sense of urgency.
• Excellent organizational skills.
• Ability to work independently, prioritize and perform several tasks without losing concentration.
• Professional and efficient verbal and written communications.
• Promote teamwork by working collaboratively with colleagues and management to achieve shared goals.

Physical Requirements:

• Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards; including meeting qualitative and/or quantitative productivity standards, and maintain regular in-person punctual attendance.
• Must be able to talk, listen and speak clearly on the telephone and in person with co-workers, patients, customers, and other visitors.
• Light physical effort. Requires long periods of sitting. Must be able to lift and carry up to 25 lbs.
• Constantly uses and operates standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

This description reflects management’s assignment of essential functions. It does not proscribe or restrict the tasks that may be assigned. This job description is subject to change at any time.