Accounts Receivable Representative (Medical)

Job Description

Job Description

This position is responsible for providing excellent customer service while answering questions from patients, staff, and insurance companies. The Billing Specialist/AR Representative will also have proper phone etiquette, computer skills, and the ability to multi-task and work well independently and as a team member in a fast-paced environment, collaborating effectively with all departments and cultivating a nurturing atmosphere of courtesy, compassion, respect, empathy, dignity, and optimism. This position will prepare and maintain all aspects of the clinic environment.

JOB DUTIES:

• Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
• Timely follow-up of all claim denials.
• Submits corrected claims in a timely manner.
• Timely submission of appeals.
• Responds to inquiries from the insurance company, patients, and providers.
• Submits insurance/patient refunds in a timely manner.
• Analytically examines accounts.
• Identifies payer-specific trends.
• Informs Management of any known issues.
• Does part to prevent fraud and abuse.
• Participates in educational activities, reviews coding, and billing updates.
• Inform Management in a timely manner of any Medical Coverage Policy updates regarding your insurance carriers.
• Sets up payment plans for patient balances.
• Special projects as assigned.
• Performs other duties as assigned.
• Maintains the strictest confidentiality; adheres to all HIPAA guidelines/regulations.

Other functions:

• Performs other logically associated duties that enhance position through Continuous Quality Improvement.
• Serves as a preceptor for new Employees.
• Competent in communication with patients, including current working knowledge of medications, interventions, and procedures provided.
• Competent in computer applications pertaining to the position.

BASIC QUALIFICATIONS:

• High school diploma or equivalent required.
• 3 years of billing experience is required.
• Good interpersonal and organizational skills.
• Highly detail oriented with a critical degree of accuracy regarding data entry.
• Ability to analyze A/R Aging reports and prioritize work accordingly.
• Knowledge of medical billing/collections practices, computer programs, business office.