Job description

We are seeking a full-time Medical A/R Rep in our billing office.

Duties/Responsibilities include but are not limited to:

• Effectively review and research claims denials and contact payers to verify detailed denial reasons when necessary
• Contact patients to obtain accurate insurance information.
• Phone appeals & reconsiderations for denied or rejected claims.
• Must be able to identify and communicate denial/rejection trends to management
• Follow up on all claims from billing through final resolution
• Correct and identify billing errors and resubmit claims to insurance carriers·
• Review insurance EOB and initiate appeals and as necessary·
• Respond to Payer’s request for additional information/documentation· Posting account adjustments as a result of written communication from third parties (i.e. certain contractual adjustments)·
• Answer incoming calls and assist insurance carriers with their requests· Communicate patient responsibility with patient·
• Collect on patient balances and/or establish a payment plan·
• Review weekly schedules for patients with upcoming appointments, contact patients and communicate to front desk arrangements made to collect balances·
• Return mail (patient statements), contact patient to obtain correct billing address and/or payment

• Navigate and research insurance policies & benefits for policy exclusions for patients.
• Navigate and research payer medical reimbursement policies and exclusions.
• Complete request for reconsideration forms while following payer requirements.
• Prepare documentation and file appeals and reconsiderations as appropriate.
• Review and work all daily correspondence received from patients and payers.
• Must be aware of the timely filing guidelines associated with reconsiderations and appeals for assigned payers.
• Review accounts for accuracy (payments and adjustments)
• Knowledgeable of medical EOB’s, patient deductibles and co-pays, and insurance or third-party correspondence.
• Experience working with payer websites.
• Experience in working-aged AR
• EDI transactions/troubleshooting.
• Other assigned duties.

Job Requirements:

• High School Diploma or GED preferred.
• Minimum of 4 years of medical billing, collections, and payment posting experience.
• Certified Professional Coder (preferred but not required)
• Knowledge of CPT Coding, ICD10, and use of appropriate modifiers
• Experience working appeals and composing appeal letters
• Knowledge of bundling and global periods
• Experience working in Microsoft Word & Excel, Outlook, Teams, & Athena is a PLUS!
• Experience working in medical collections, both insurance and patient
• Urology and medical terminology
• Knowledge of insurance plans, claims, and billing processes.

Job Type: Full-time

Pay: $15.00 - $20.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Application Question(s):

• Salary Requirement

Education:

• High school or equivalent (Preferred)

Experience:

• Medical billing: 4 years (Preferred)
• collection: 3 years (Preferred)
• payment posting: 3 years (Preferred)

Work Location: One location