Accounts Receivable Representative

* Perform patient and insurance for various revenue cycle activities; such as working rejections, no activity follow up accounts, registration-related functions, eligibility inquiries and other activities that contribute to AR/Account Resolution.
* Perform revenue cycle activities to resolve the account balance, such as resolving claim edits, rejections, resolve complex Provider Level adjustments (PLBs) credit balances, applying payments and adjustments to accounts.
* Responsible to make insurance follow-up phone calls to payers to resolve missing remit file issues.
* Work with IT to resolve EDI file load errors and work with payers to resolve missing remit file issues.
* Communicate with revenue cycle experts regarding the necessary medical records and clinical and/or billing information needed from the department to resolve accounts and escalate issues when appropriate to revenue cycle experts and/or manager.
* Complete daily payment batch reconciliation and create/update accounts within the billing system; including demographic and insurance changes or additions; also maintain documentation within the billing system for account activity.
* Assist in tasks related to projects and in the development, coordination and review of procedures.
* Correspond with internal and external constituencies to obtain appropriate documentation and/or information in an effort to resolve the account.
* Working knowledge of physician revenue cycle and accounts receivable processes, including claim submission, denial management, payment posting, and AR follow up.
* Ability to analyze account activity, identify root causes of unpaid or underpaid claims, and take appropriate action to resolve balances and reduce AR.
* Effective communication with third party payers, patients, and internal departments to research claim status, resolve denials, and obtain required information.
* Strong attention to detail and accuracy when reviewing accounts, updating demographic and insurance information, and applying payments and adjustments.
* Proficiency in or ability to quickly learn billing systems, EMR platforms, and standard office software, with consistent and accurate documentation of account activity.
* Demonstrated problem solving skills and sound judgment, including knowing when to escalate issues to subject matter experts or leadership.
* Ability to manage assigned workload independently while meeting productivity, timeliness, and quality expectations.
* Ability to work effectively as part of a team, communicate professionally, and interact with patients, faculty, staff, and external partners with tact and courtesy.
* Consistent adherence to established procedures, policies, and expectations within a union represented environment.
* Ability to understand medical terminology/documentation and basic documentation such as help screens and departmental handouts.
* Ability to handle multiple concurrent tasks in competent and professional manner in a fast paced atmosphere.
* Ability to solve problems independently with limited direction from the supervisor.
* Previous experience with physician billing required.
* Previous experience using electronic medical records (EMR) systems preferred.
* Previous experience with diagnosis and CPT coding terminology required.
* Previous experience working with third party payor rules, procedures and policies in physician billing required.
* Previous Epic EMR experience preferred.
* Previous experience working all Government Payors including but not limited to Medicare, Medicare Advantage Plans, Medicaid and Medicaid MCO’s preferred.
* Working knowledge of physician billing and accounts receivable processes, including claim submission, denials, payment posting, adjustments, and AR follow up.
* Understanding of diagnosis and CPT coding terminology and third party payer rules as they apply to physician billing.
* Experience using electronic billing systems to update patient demographics, insurance information, and document account activity.
* Experience working within electronic medical record systems;
Epic experience preferred.
* Proficiency with Microsoft Office applications, including Outlook, Word, and Excel.

When applying, the document(s)
** MUST
* * be uploaded via the
** My Experience
** page, in the section titled
** Application Documents
** of the application.

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