Healthcare AR Follow Up Representative

Job description

The Accounts Receivable Representative is responsible for the follow-up on identified government and non-government claims including Medicare /Medicaid and Government HMO. The incumbent will resolve unpaid accounts in a timely and efficient manner for one or more geographical areas, while maintaining quality and productivity standards set for the Level 1 A/R Follow-up Representative.

Responsibilities:
• Review eligibility, verify insurance benefits, and/or perform insurance discovery activities required to generate a clean claim.
• Review, modify as necessary, and re-bill rejected/denied claims in “queue” by assigning appropriate insurance carrier, utilizing the billing address and/or payor prefix.
• Process “queues” within appropriate timeframes, (e.g. claims status checks, appeals of denied claims).
• Recode claims, assigning proper condition codes/ICD-9 codes/procedure codes into the Accounts Receivable Billing System and re-file claims as necessary.
• Update appropriate modifiers, based on origin and destination of trip and change insurance claims as necessary.
• Create narrative in the Accounts Receivable Billing System to document status of trip for use in claim appeal process.
• Other duties as assigned.
• Work in a spirit of teamwork and cooperation.
• Convey a sense of competence and commitment.
• Use initiative to learn new skills, enhance personal knowledge and improve communications.
• Demonstrate an ability to work well with team members.
• Communicate a willingness to help others succeed.
• Share workspace and resources as necessary.

Qualifications:
• High School Diploma or GED required, Associates Degree or certificate of completion from a coding and billing school preferred. Examples: Certifications
• Minimum one (1) year previous medical billing experience required; ambulance billing experience preferred.
• Medical transportation processes.
• Terminology on a PCR, Hospital Face Sheet, and/or a CAD Sheet.
• Process of signature and paperwork compliance.
• Payor-specific requirements for one or more geographical areas and/or financial classes.
• Distinctions between ALS/BLS/SCT/Gurney/Wheelchair/CCT levels of service.
• ICD-9 coding/condition codes and procedure codes.
• Government coverage guidelines, filing limits and necessary prior authorizations.
• Medical terminology and insurance terminology.
• Internal Compliance guidelines.
• Appeal levels and the redetermination process.
• HIPAA requirements.
• Proficient in the Accounts Receivable Billing System and Internet, (e.g. Internet mapping programs, eligibility websites, address search engines).
• Basic understanding of Microsoft Word and Excel.
• Communicate effectively, (both orally and in writing) in English.

Benefits

Integra Connect, LLC provides a comprehensive benefits plan.
• Medical/Dental/Vision Insurance beginning the 1st of the month following your date of hire
• Paid Time Off
• 401k with employer match
• Paid Holidays and Floating Holiday

Equal Opportunity Employer

Job Type: Full-time

Benefits:
• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:
• Monday to Friday

Work Location: Remote

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