Specialist, CBO Accounts Receivable Insurance

4 weeks ago

Birmingham, United States North American Credit Services Full time
Job DescriptionJob Description


Accounts Receivable Representative, CBO

About MedSrv

As the healthcare industry continues to grow, so does the need for consistent, effective Revenue Cycle Management. But it takes more than just technology and technical expertise. It takes innovation, a willingness to adapt, and passion to deliver the best. MedSrv, LLC is the difference in Revenue Cycle Management.

We’re looking for an A/R Insurance Representative to join our growing team. The Insurance A/R Follow-up Representative will be responsible for reviewing unpaid, underpaid, denied or unresolved insurance balance patient accounts submitted to various health care payers. The primary focus of the AR Rep is to review claims for accuracy and completeness, timeliness and correctness of payment from payers, and rebilling / appealing as appropriate to resolve any underlying errors in claims submission and account resolution and meet performance-based goals. If you're ready to contribute to our mission of guiding by faith and serving with integrity and compassion, we want to hear from you Join the MedSrv team and be part of a company committed to excellence in Revenue Cycle Management.

Schedule: Full-timeLocation: RemoteCompensation: $18.00/hr. Benefits for you and your family:
  • Paid time off
  • Full benefits package
  • Matching 401k plan
  • Balanced work-life schedule – NO WEEKENDS
  • Casual work environment
  • Career Development
In this role, you must:Read, and understand with proficiency, and interpret Explanations of Benefits (EOBs) from various insurance carriers. Familiar with medical terminology, including CPT and ICD-10 codes. Solid experience in processing claims and managing insurance appeals and disputes. Serves as the main liaison between health insurance and healthcare systems. Skilled in using payer websites/portals to check insurance guidelines, claim statuses, and eligibility requirements. Adept at handling authorization denials and conducting follow-ups. Capable of employing various systems/platforms for research and analytical purposes.

You will bring value to the team by:
  • Performs insurance follow up on unpaid claims utilizing payer website and/or AVR. Assigned claims should be completed thoroughly to include the action taken to have corrected claim reprocessed or appealed.
  • When assigned accounts receivable reports; work and complete them in accordance with the work instructions provided. Email the supervisor if unable to meet the timeframe.
  • Meet productivity standards:
    • Follow Up and Denial reps should maintain a daily average of 50 claims (minimum) per day on Managed Care, Medicare & Medicaid, and all other payers.
    • Medical records reps should maintain a (minimum) daily average of 30 claims
  • Escalate claims to the correct coding contacts for corrections to be made by the coders with appropriate details of what needs to be reviewed.
  • Responsible for forwarding and providing updated information to Supervisor.
  • Must know the client specialties, locations, and proper A/R information.
  • Communicate claim trends resulting in denials or a decrease in payments. This information is to be sent to management with the payer, provider(s), number of claims and dollar amount affected.
  • Keeps management informed of client problems on communication and correspondence.
  • A new employee must be able to meet the established and agreed upon goals within 90 days of continuous employment.
  • Must have the ability to concentrate for extended periods of time.
Requirements you must have for success:
  • High school diploma or equivalent is required; Medical Coding degree/certificate or an Associate degree is preferred
  • Prior relevant work experience in AR/Medicaid/Commercial health insurance processes.
  • Demonstrated customer service experience and/or experience in a customer service-oriented environment.
  • Strong customer service orientation with demonstrated commitment to meet/exceed customer needs.
  • Ability to maintain reliable and predictable attendance.
  • Strong verbal/written communication and interpersonal skills.
  • Demonstrated ability to work in a fast-paced, structured environment, handling large call volumes.
  • Computer proficiency is essential.
  • Self-directed with the ability to perform both as part of a team and individually.
  • Ability to adapt and work effectively in a continuously changing environment.
  • Consistently demonstrate a high level of professionalism through a strong work ethic that positively influences the work habits of the team.
  • Detail-oriented with a focus on quality and consistently meeting goals.

Language Skills:

Ability to: read and comprehend complex instructions, correspondence, and memos; write and present information to leadership, vendors, clients, and other employees of the organization.

Mathematical Skills:

Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Have the ability to compare rate, ratio, and percent and to draw and interpret various graphs.

Reasoning Ability:

Ability to: deal with problems involving several concrete variables in standardized situations; plan, organize, delegate, and prioritize work; provide clear and effective direction to staff; communicate effectively orally and in writing; establish and maintain effective working relationships with MedSrv departments, vendors, other businesses, and our clients; Must be able to multi-task.

Physical Demands:

You may be required to lift between 30-50lbs at times. Limited.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The noise level in the work environment is usually moderate.

We are an equal-opportunity employer and believe in the power of a diverse, inclusive team. We welcome all applications from all suitably qualified people, regardless of race, sex, disability, religion/ belief, sexual orientation, or age. Please let us know if you require anything which would enable your success throughout our interview process.


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