Basic Function: The Accounts Receivable Representative will be responsible for achieving accurate and timely accounting of all Physician Billing accounts receivable as set by policies and procedures. This includes the daily review and posting of charges, payments and adjustments to the patient accounting system, review outgoing data and correct errors, review and resolution with insurance companies and patients of outstanding accounts receivable. Requirements: Education: High School Diploma or Equivalent required. Associates degree preferred.
Experience: 2 years of accounts receivable experience a hospital, healthcare or private professional accounts receivable setting required. Must have knowledge of medical records, medical terminology and billing requirements, CPT, HCPCS and ICD-9 coding and be able to apply such coding to a descriptive procedure and / or diagnosis. Basic accounting skills preferred. Windows-based software required, including but not limited to Microsoft Windows, Excel and Word. Experience with Siemens Soarian systems and Allscripts electronic health record preferred. Must understand managed care concepts and healthcare regulations. Excellent communication (verbal, written and phone), interpersonal and positive customer relations skills required. Certification: N/A High School Diploma or Equivalent required. Associates degree preferred. Two (2) years' of Accounts Receivable experience a hospital or healthcare setting. Must have knowledge of medical records, medical terminology and billing requirements, CPT, HCPCS and ICD-9 coding and be able to apply such coding to a descriptive procedure and / or diagnosis. Windows-based software required, including but not limited to Microsoft Windows, Excel and Word. Experience with Siemens Soarian systems and Allscripts electronic health record preferred. Responsibilities: Responsible for achieving accurate and timely accounting of all assigned physician billing accounts receivable as set by policies and procedures. Responsible for reviewing, payments and adjustments to the patient accounting system on a daily basis, and ensuring outgoing data is accurate. Review and resolve outstanding accounts receivable with insurance companies and patients. Review daily claims in dispute with payers to ensure the provider and payers are in agreement for appropriate claims reimbursed. Attend monthly payer meetings to continuously improve communications between provider and payer in order to resolve issues, reduce outstanding aged accounts, increase cash flow, and receive any updates on insurance regulations. Handle and process all customer calls and written requests into the Physician Billing Office (PBO) and responds in a timely manner to challenging customers, patients, insurance companies, other healthcare providers, physicians and adverse situations, in a professional and courteous manner. Provide assistance and information on programs to assist patient and family financial issues (i.e. Medicaid Program, Uncompensated Care). Review Billing Exception Report daily for registration or data entry error and make corrections. Review Omnipro daily for electronic billing errors and make all required corrections as assigned. Review and monitor all errors to determine whether or not an error has occurred due to system problems or registration errors. Track all registration errors and report error to the manager as necessary for interdepartmental communication. Log and forward to the source for correction if there is a registration error or missing claim form. Once all errors have been identified and corrected, each claim will be reviewed to verify if attachments are required for submission (i.e. Primary carrier payments, Medical Records, Workers Compensation C-4 or No Fault forms), then claims will be submitted daily to the appropriate payer as indicated. Notify the supervisor when a system error occurs or after one week if errors are awaiting resolution from the source. Analyze 277 Rejection Remittance Reports to verify all payer denials, including eligibility denials, and edit denials. Calculate the usual and customary rate for any deductibles, coinsurance and / or adjustments according to the Professional and Technical reimbursement and contracts procedures and policies. Utilize all appropriate Financial System transaction codes for payments and allowances. Assist the cash posting staff with any questions in regards to payer remittances to ensure timely cash posting. Ensure appropriate Financial System transaction codes are applied to payments and allowances. Research unidentified cash with the payer for correct posting, or complete a refund request for the payer within 30 days. Apply appropriate zero payment transaction code to claims denied by an insurance carrier. Review each denial for appropriateness and either correct or bill to the next responsible party. Follow up on aging accounts with each payer within 15 to 45 days from insurance / guarantor bill date. Each account must show some activity that explains its age (i.e. Online Comment from follow up, payment arrangements, etc.). Send appropriate correspondence to insurance companies and guarantors to obtain payment status or make arrangements. Daily completion of enhanced work lists Accomplish the days tasks as set forth by the position, policies and procedures. Complete required training as assigned. Responds promptly to customer requests, provide excellent customer service and collaborates with other departments throughout the organization. Adhere to patient privacy policies and procedures, maintain confidentiality. Adhere to the Making Ellis Exceptional (MEE) Behaviors & Standards and AIDET (Acknowledge, Identify, Duration, Expectation, Thank you) and initiate, promote, and support change initiatives. Perform additional duties as assigned.
- Accounts Receivable
- Cpt Coding