Surgical AR Representative

Surgical AR Representative

Responsible for overseeing out of network billing and collections success for 3-4 medical practices operating in different states from our central billing office in West Palm Beach. To identify denial trends and manage appeals for underpayment. Be able to identify, articulate, address and demonstrate root cause of non-payment or underpayment.

Job Responsibilities:

• Identifying trends in billing, coding, denials, underpayment etc.
• Updating plan IDs and Patient/Payor demographic information.
• Identifying payor issues and trends.
• Rejection and Denial management.
• Answering medical record requests related to claim resolution
• System Rejections
• Clearinghouse Rejections
• Denial and Appeal Management
• Ability to navigate Insurance portals
• Medical Record response
• Training others
• Perform other duties as assigned

Required Qualifications:

• High School Diploma or Equivalent
• 2-3 Years full-time surgical billing reimbursement experience
• Full understanding of surgical billing from hospital and ASC environment.
• Superior knowledge of coding guidelines and reimbursement schemes
• Must have exceptional organizational and computer skills
• Willing and able to follow directions and adhere to priorities
• Conversational knowledge of medical terminology, abbreviations, techniques, and surgical procedures

Preferred Qualifications:

• Excellent written and oral communication along with solid analytical skills
• Ability to work independently and with a team
• 3 years eClinical Works RCM experience in patient account and denial management

At Pelvic Rehabilitation Medicine, we value, welcome, appreciate, and celebrate differences. PRM is proud to be an equal opportunity employer. Employment at PRM is based solely on a person's qualifications directly related to professional competence. We do not discriminate based on race, color, ancestry, national origin, religion, or religious creed, mental or physical disability, medical condition, genetic information, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity, gender expression, age, marital status, military or veteran status, citizenship, or other characteristics protected by state or federal law or local ordinance.