Insurance Accounts Receivable Representative

Insurance Accounts Receivable Representative

Hours of Work : M-F

Employment Type : Full Time

Shift : Day

Overview

Under general supervision this position supports the vision and mission for The Cardiac and Vascular Institute. Expectations include, but are not limited to, Insurance verification, evaluating financial responsibility of patients, updating accounts to a billable / collectible status, researching denials, claim rejections, and delays in reimbursement, utilizing all possible means to resolve accounts, which include contacting patients, insurance companies and other departments. Assists the department by organizing collection procedures and meeting performance goals while adhering to current laws and payer regulations and reducing uncompensated care.

Key Responsibilities

• Ensures correct processing of outstanding insurance claims by : interpreting insurance payer responses, requesting account level adjustments, submitting appeals and claims reconsiderations, evaluating financial responsibility of patients, resolving insurance denials and claim rejections, performing insurance verification.
• Meets or exceeds the department's established performance targets (productivity and quality).
• Initiate and follows-up on reconsiderations and appeals.
• Exercises good judgement in escalating identified denial trends or root cause of denials to mitigate future denials, expedites the reprocessing of claims and maximizes opportunities to enhance front end claim edits to facilitate first pass resolution.
• Identifies uncollectible accounts and performs accurate and timely write-offs (e.g. no authorization) adhering to department policy guidelines.
• Based on electronic payers' error reports, makes appropriate corrections to optimize the electronic claims submission process

Knowledge, Skills and Abilities

Qualifications

Preferred Qualifications

Additional Information

All your information will be kept confidential according to EEO guidelines.