Overview
This role involves working as an Accounts Receivable Representative within a regional business office focused on healthcare revenue cycle management. The position requires thorough and timely follow-up on patient accounts to ensure accurate accounts receivable reporting. Responsibilities include working with insurance companies and third-party payers to verify payments from primary and secondary payers and self-pay patients. This role is critical to the revenue cycle process and requires adherence to organizational policies and procedures.
Responsibilities
- Work Monday through Friday with hours between 7am and 6pm local time.
- Ensure payments from primary and secondary payers and self-pay patients are accurate.
- Conduct thorough and timely follow-up on patient accounts to maintain accurate accounts receivable reporting.
- Achieve and maintain cash collection metrics and goals.
- Independently handle second-level reimbursement issues, including contracted and non-contracted denials for services before and after procedures.
- Operate effectively in a fast-paced environment requiring attention to detail, accountability, teamwork, and professional behavior.
- Collaborate closely with payer provider relations representatives.
- Contact insurance companies via email and phone to collect payments.
- Manage reimbursement issues related to contracted and non-contracted plans including HMO, PPO, EPO, POS, Worker’s Compensation, self-pay, and third-party payers.
- Work all denials and corrected claims in collaboration with billers, business office managers, insurance payers, and patients on past due accounts.
- Manage credit balances, patient balance resolution, and non-patient (insurance) resolution.
- Focus primarily on collecting payments from insurance companies rather than self-payers.
Requirements
- High School Diploma or GED.
- Recent experience with healthcare denials and appeals is required.
- Familiarity with Explanation of Benefits (EOB) and the ability to read medical policies from payers.
- Experience with Medicare and Medicare Advantage Plans is preferred.
Compensation & Benefits
- Hourly pay range: $21.00 to $23.00 per hour.
- Benefits include health and dental insurance options, paid time off, 401(k) plan with company match, life and disability insurance, and more.
- Benefits eligibility begins on the first day of employment.
Location
- Work schedule is Monday through Friday with hours between 7am and 6pm local time zone.