Job Description:

• PURPOSE OF JOB : To identify, analyze and resolve unpaid insurance receivable balances that exceed the third party payer clean claim payment cycle and resolve reimbursement issues to guarantee the timely, efficient and maximum reimbursement for services performed. The Accounts Receivable Billing Representative performs customer service and accounts receivable duties utilizing their knowledge of third party billing, collections, hospital systems, payer technology, procedures, regulations and interdepartmental functions to resolve patient inquiries and outstanding balances in an expeditious manner while providing excellent customer service. This person encounters constant communication and problem solving situations with Payers, Patients as well as internal customers and must have the ability to handle all encounters with consistent, well-developed service skills.

• ESSENTIAL FUNCTIONS :

• Research and resolve unpaid or underpaid Insurance balances on a daily basis. Monitor reports to assure all balances are received and processed in a timely manner while maintaining Department Standards. Identifies and communicates to manager possible system and reimbursement problems to facilitate an efficient and accurate review of the payers.

• Research and resolve third party payer payments while meeting strict department deadlines.

• Maintains appropriate proficiency in Hospital Billing systems, as well as proficiency using external computer-generated media to monitor and promote prompt and accurate patient account reimbursement.
• Research, review and process all correspondence received for accuracy. Will make corrections when needed to insure that all claims are correct. Reviews, researches and amends correspondence/insurance payments and makes appropriate adjustments to accounts as per third party regulations.

• Runs multiple reports, and reviews claims for accuracy. Contacts necessary hospital associates for clarification, and make corrections when needed in order to ensure the claims will transmit electronically.

• Carry out responsibilities with an adherence to professional standards, a commitment to performance improvement, and an interest in professional growth and development.

Job Qualifications:
QUALIFICATIONS :

• Education: High School Diploma or equivalent required.

• Experience: 1-2 years' experience in third party health care billing, 3-5 years strongly preferred

2 years' experience with computerized billing systems

2 year customer service experience preferred

2 year PC experience, using window technology require

• Other Skills: Ability to negotiate and problem solve independently

Must have a good understanding of CPT and ICD-10 codes

Knowledge of medical terminology

Ability to prioritize and handle multiple tasks

Ability to communicate clearly both verbally and in writing

Good math and analytical skills

Ability to type the minimum of 35 wpm

Ability to work productively as part of a team

• Training Time Required once Hired 5 - 7 months