Accounts Receivable Representative

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a detail-oriented and experienced Out of Network Accounts Receivable (A/R) Representative to join their healthcare finance team. The ideal candidate will be responsible for managing and resolving out-of-network insurance claims and ensuring timely and accurate reimbursement. This role requires a strong understanding of medical billing, coding, and insurance procedures, along with excellent analytical and communication skills.

Key Responsibilities

• Claims Management:
  • Review, submit, and follow up on out-of-network insurance claims to ensure timely payment.
  • Investigate and resolve claim denials and discrepancies by working with insurance companies, patients, and internal departments.
  • Appeal denied or underpaid claims by providing necessary documentation and evidence.
• Account Reconciliation:
  • Reconcile payments and adjustments, ensuring accuracy in patient accounts and financial records.
  • Monitor accounts receivable aging reports and take proactive measures to collect outstanding balances.
  • Perform audits on patient accounts to identify and rectify errors.
• Communication:
  • Communicate with insurance companies to verify coverage, obtain authorizations, and clarify payment policies.
  • Serve as a point of contact for patients regarding billing inquiries, providing clear and accurate information.
  • Collaborate with internal departments, including billing, coding, and patient services, to streamline processes and improve reimbursement rates.
• Documentation and Reporting:
  • Maintain accurate and detailed records of all claims, payments, and communications with insurance companies.
  • Generate regular reports on account statuses, collection activities, and financial performance metrics.
  • Ensure compliance with federal, state, and payer-specific billing regulations and guidelines.

Qualifications

• Someone in a billing role within an office/system environment
• Physician billing experience
• Experience with commercial payers
• Skills in reviewing claims
• Experience working appeals and denials

Preferred Skills

• Out-of-Network AR Experience highly preferred

Schedule/Shift

Monday-Friday 9AM-5PM - Flexible schedule

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Our client provides a temp-to-perm opportunity within a family-style office environment, fostering future growth opportunities.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

* As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities.

Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.