Accounts Receivable Representative II
Envision Healthcare
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteJob Level
JuniorMid-Level
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
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