A​/R Pending

Description

South Coast seeks a full time Accounts Receivable Insurance Rep

Responsible for the collection of all outstanding pending insurance patient account balances and to resolve patient account issues in order to collect account balances according to department policies and procedures. Responsible for working with self pay insurance staff to resolve patient account issues in order to collect account balances.

• Responds promptly to, and handles, all telephone inquiries received from physicians, patients or insurance companies.
• Responsible for knowing and understanding Accounts Receivable policies and procedures as established by the Director of Accounts Receivable.
• Processes correspondence in accordance with established Accounts Receivable Department policies and procedures.
• Provides financial counseling to patients and makes financial arrangements for installment payments while communicating in a culturally and linguistically appropriate manner. Obtains approvals according to established policies and procedures.
• Coordinates collection process in accordance with established policies. Obtains signature of provider with highest balance on account, to authorize placement for collection and write off. Places accounts for collection, meets correspondence deadlines.
• Keeps up to date through internet web portals of insurance carriers, with posted newsletters and informational postings to keep current on changes that affect Accounts Receivable, collections, department policies and procedures.
• Communicates with supervisor and providers regarding updates and denials from insurance carrier by meeting with either or both, a minimum of once per month.
• Keeps supervisor advised of insurance carrier changes that may affect existing policies and procedures.
• Reviews, researches and resolves all claims denied by insurance companies. Re-files claims as required to receive payment. Resolves claims through web portals or telephone, in order to secure payment.
• Reviews, researches and resolves all claims that appear on the unpaid claims management report. Re-files claims through web portals, fax, paper, or electronically (in that order), in order to secure payment.
• Reviews Credit Balance monthly and processes refunds according to refund procedures and approval process.
• Reviews Aged Insurance Pending Report and works accounts in all categories, (over 91 days, 6190 days and 31-60 days).
• Reviews Medicare accounts and any other electronic submission problems, determines corrective action, corrects, and resubmits to carrier for payment.
• Runs Final Charge and Receipt Summary at the end of each day for balancing. Balances all charges, receipts, adjustment write offs.
• Meets monthly goals as established by department head.
• Reports to work on a regular and consistent basis.

Requirements

• High School graduate or equivalent.

• Minimum of 2 years experience in doctors office or medical insurance company, preferably in accounts receivable or collections or claims area preferred.
• Computer skills.

• Two years of Medical Billing.

• Knowledge of 3rd party insurance processing.
• Knowledge of insurance terminology.
• Knowledge of insurance coverage and benefits. Knowledge of collection techniques.
• Knowledge of customer service concepts and techniques including the importance of appropriate image.
• Knowledge of automated collection systems.

• Skilled in use of computer skills, preferably MS Word.
• Skilled in use of Internet.
• Skilled in use of customer service concepts and techniques to work with providers, patients, patients’ families, and coworkers.

• Ability to exercise professionalism in dealing with all levels of personnel, patients, and patients’ families.
• Ability…