Accounts Receivable Representative II
Envision Healthcare
full-time
Posted on:
Location Type: Remote
Location: United States
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About the role
- Resolves third party outstanding accounts throughout the client base by means of researching claim status, identifying and resolving issues, and processing denials or other correspondence received from various payors.
- Utilizes proprietary software to process rejections, denials and other correspondence received from third party payors in accordance with procedures and guidelines to resolve issues and re-bill clean claims for payment.
- Acquires, interprets, and applies payor rules/regulations to ensure claims and appeals are submitted/processed in accordance with proper guidelines.
- Researches complex payor issues preventing payment and communicates the details to appropriate internal personnel for resolution.
- Analyzes patient account history in order to resolve claim issues.
- Accurately documents the system notes screen regarding any actions or updates made to the patient account.
- Investigates outstanding accounts, identifies issues/denials preventing resolution and communicates findings to appropriate management personnel.
- Serves as the primary contact for all inbound calls from insurance companies to resolve problems and answer questions.
- Attends meetings within and outside of the department, and presents information as needed.
- Assists in the mentoring of new representatives to the department.
- Processes special projects as assigned by the supervisor and other management staff.
- Prepares mass appeals for large and complex payor/provider issues.
- Contacts hospitals, employers, and payors for verification, claim status, and to obtain additional information to satisfy processing of the claims for payment.
- Maintains all department standards associated with productivity, quality, and phone statistics.
- Communicates with other departments to identify and resolve issues causing rejections and denials, utilizing applications and databases.
- Composes appeal letters to third party payors and compiles all proper documentation including but not limited to claim forms, payor specific forms, and medical documentation as applicable.
- Utilizes all resources and websites as a tool to retrieve pertinent information to accounts related receivable tasks and assignments
Requirements
- High School graduate or equivalent required.
- Associate or bachelor’s degree in business administration or related field preferred.
- 1 - 2 years of accounts receivable collection experience in healthcare required.
- Anesthesia accounts receivable collection experience is strongly preferred.
- Working knowledge of medical billing/insurance terminology.
- Working knowledge of Medicare, Medicaid, and Blue Shield rules and regulations.
- Handle a large volume of work.
- Meet or exceed established standards for productivity and quality.
- Flexible, high achiever with ability to learn quickly and meet department goals and deadlines.
- Strong attention to detail.
- Ability to compute percentages and basic math functions.
- Ability to identify and solve moderate to highly complex problems independently.
- Organized, detail oriented with excellent follow through abilities. Can handle and prioritize multiple tasks. Reliable, team-oriented, pleasant with excellent interpersonal skills.
Benefits
- Medical
- Dental
- Vision
- Life
- Disability
- Healthcare FSA
- Dependent Care FSA
- Limited Healthcare FSA
- FSAs for Transportation and Parking & HSAs
- Paid Time Off (PTO)
- 9 observed holidays
- Paid family leave
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
accounts receivablemedical billinginsurance terminologyclaim processingappeals preparationproblem solvingdata analysisdocumentationmath functionspayor rules
Soft Skills
attention to detailorganizational skillsinterpersonal skillscommunication skillsflexibilityreliabilityteam-orientedability to prioritizementoringhigh achiever
Certifications
high school diplomaassociate degreebachelor's degree