Job Description:

Work with insurance carriers regarding claim status and denial management. Follow policy and procedures along with applying federal and state guidelines to collection efforts. Interpret and follow up on the Explanation of Benefits. Assure timely collection of accounts receivables, monitoring the account activity and providing adequate follow-up to ensure maximum reimbursement is received. Maintain quantity and quality of assigned work. (It's not a remote position)

Responsibilities:

• Takes appropriate actions on denied charges to ensure claims are paid on the first follow-up call or appeal.
• Works with assigned queues, aging and denial reports to accomplish the set goal for the position.
• Responsible for learning, understanding and following payer guidelines.
• Notifying management of payer policy changes.
• Ensuring appropriate information is submitted to insurance companies in order to expedite payment.
• Completes appropriate adjustments and refund requests based on contract, modifiers or appeal denials.
• Handle incoming calls for information requests from insurance companies and patients.
• Works to understand the operative notes that dictate procedures billed.
• Reallocate misapplied payments and adjustments.
• Work special assignments when needed.
• Utilizes the coding resources (CPT, ICD-10, CDR, AAOS books) to understand procedures that are denied.
• Documents accounts correctly.
• Assure compliance with all company plans, policies and procedures set forth by the Billing & RCM Services.
• Create invoices every month
• Call customers and get paid for those invoices
• Update spreadsheets and keep accurate records
• Reconcile customer accounts and resolve billing discrepancies
• Monitor accounts to ensure timely and efficient collections
• Prepare reports on accounts receivable status and aging
• Collaborate with other departments to resolve issues and improve processes
• Provide excellent customer service and communication with customers and staff

Education and Experience:

• Two years prior AR experience
• High school diploma or equivalent
• 2 years’ of experience in billing, A/R follow up and/or denials management & appeal writing

Qualifications, Skills Abilities and Competencies:

• Preferred prior laboratory billing and coding experience but not required.
• Basic understanding of an Explanation of Benefits (EOB)
• Basic knowledge of CPT, ICD-10, and HCPCS coding standards
• Highly organized, with strong attention to detail.
• Ability to manage large workload, while producing quality work in a fast-pace environment with interruptions and deadlines.
• Advanced ability to communicate verbally and in writing in English.
• Proficiency with PC's to include knowledge of MS Office (Outlook, Word, Excel and PowerPoint), maintaining data bases, generating information and tracking status using proprietary software.
• Ability to produce detailed reports, particularly in Excel.
• Ability to build effective relationships.
• Ability to contribute to building a strong and positive team spirit.

Job Type: Full-time

Pay: From $20.00 per hour

Schedule:

• Day shift
• Monday to Friday

Education:

• High school or equivalent (Preferred)

Work Location: In person

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