Medical AR Follow Up/Revenue Cycle Representative

Job Title: Medical AR Follow Up/Revenue Cycle Representative- On Site

Department: Follow Up

Report To: Follow Up Manager

Schedule: Monday-Friday: 8 AM-4:30 PM or 8:30 AM- 5PM

Job Summary

Example: The Medical AR Follow Up/Revenue Cycle Representative supports PATHS’ mission by assisting patients and families in securing appropriate health coverage, resolving billing issues, and advocating for financial resources. This role ensures accurate documentation, compliance with HIPAA and healthcare regulations, and contributes to timely revenue recovery for PATHS’ provider clients across multiple states.

Company Information

Physician and Tactical Healthcare Services (PATHS), LLC is committed to provide the best possible environment for maximum development and goal achievement for all employees. Our practice is to treat each employee as an individual. We seek to develop a spirit of teamwork; individuals working together to attain a common goal. In order to maintain an atmosphere where these goals can be accomplished, PATHS provides a comfortable and progressive workplace. We take into account individual circumstances and the individual employee. 

Founded in 2000, PATHS offers a broad range of account receivable management, patient advocacy, and consultation services to assist the needs of our healthcare clients. Our 4 offices in PA, NJ, and DE are home to 450 employees and that serve over 100 clients. Our team has built flourishing long-term partnerships with clients and staff by cultivating a great experience.

Essential Duties & Responsibilities

· Exporting, importing and submitting claims from one system to another system

· Resolve billing discrepancies and denials/rejections promptly and efficiently

· Analyzing/understanding Explanation of Benefits (EOB) or Remittance Advice (ERA) received from an insurance carrier and take appropriate action according to company guidelines/processes per the client

· Follow-up with insurance companies via phone calls or payer portals on denials/payments

· Ability to find trends and able to research payer policies/guidelines to provide back to the management team

· Correcting and resubmitting claims

· Documentation and data entry

· Able to monitor accounts receivable follow up work queues/reports

· Other duties as assigned

Supervisory Responsibilities

This position has no supervisory responsibilities.

Required Skills & Abilities

• Working knowledge of Medicaid

• Familiarity with various insurance carriers and online portals 

• Understanding of medical terminology including CPT and ICD-10 codes

• Ability to meet productivity goals

• Excellent interpersonal skills both written and verbal

• Working knowledge of Microsoft applications: Outlook, Word, and Excel

• Organized, detail oriented, strong problem solving and research skills

Education & Experience

High school diploma or GED required; secondary education preferred
Working knowledge of an EMR system Navinet / EPIC experience is a plus!

Minimum 1 year of medical billing follow up experience required  

Knowledge of a CMS-1500 claim form for Physician Billing required  

EPIC follow up experience- preferred

Physical & Environmental Requirements

• Prolonged periods sitting at a desk and working on a computer.

• Frequent movement in hospital or office settings, including walking between patient rooms and departments.

• Occasional lifting of up to 15 pounds.

• Must have reliable transportation and valid driver’s license for travel to client sites as required.

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Pre-Employment Requirements

Offers of employment are contingent upon successful completion of applicable screenings consistent with federal, state, and local laws.
Screenings may include: background check, drug screen, physical exam, PPD screening, and verification of immunization records (role-specific).
Employment eligibility will be verified through I-9/E-Verify.
Because PATHS operates in the healthcare industry, certain screenings (e.g., OIG/GSA exclusion checks, state Medicaid exclusion lists) may be conducted on a recurring basis as required by federal and state law, client contracts, and hospital compliance programs.

Compensation & Benefits

Compensation: $18.00 – $24.00/hour
Benefits include: Paid Time Off, Paid Holidays, Medical, Dental, Life Insurance, Short-Term Disability (STD), Long-Term Disability (LTD), and a 401(k) Plan with company match.

EEO & Compliance Statement

PATHS is an Equal Opportunity Employer and complies with all applicable federal, state, and local employment laws. We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, or any other status protected by applicable law. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

Compensation details: 18-24 Hourly Wage

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