Accounts Receivable/Collections Representative
3 weeks ago
Please make an application promptly if you are a good match for this role due to high levels of interest.
MAIN FUNCTION:
• Ensures that claims are accurately reimbursed to the facility in a timely manner.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
• Review accounts receivable on a monthly basis to determine which accounts are past due.
• Follow up on all recent claims, approximately four (4) weeks after the claim is submitted. Utilizing the websites for claim follow up and contacting the insurance company as needed to ascertain receipt and possible issues inhibiting claim payment. Resubmit claim if necessary and prepare any additional paperwork needed to process that claim. All movements must be noted in the Follow Up Entry form in the billing system, and the next follow up date must be documented and adhered to.
• Past Due Claims: Contact is to be made with the insurance company representative on a minimum of a bimonthly schedule to determine the reason delay in payment. Additional information required by the insurance company is to be processed within forty-eight (48) hours. Continuous aggressive follow up will be maintained on these claims. Requests for medical records will be forwarded to the Medical Records Department with the appropriate follow up. All movements must be noted in the Follow Up Entry form in the billing system.
• Daily correspondence, explanation of benefits, etc., from insurance companies will be dealt with promptly and efficiently. This includes all follow up delegated by Billing Director or appointed representative in charge of cash posting.
• Clients will be contacted regarding outstanding bills and routine inquiries in a tactful, effective, and confidential manner.
• All inquiries from insurance companies and clients will be dealt with immediately, remembering to pay attention to HIPAA guidelines.
• Assistance will be provided to all other Billing/Accounts Receivable representatives when appropriate in order to ensure timely billing of all insurance companies. This will include financial entry, insurance verification's, website imports, self-pay breakdowns, and payment posting.
• Maintains accurate notes on client's account with regards to claim status.
• Maintains an accurate and organized filing system for all accounts assigned.
• Maintain and update Billing/AR files in billing system.
• Generate all time off requests through the Employee Portal and have supervisor approval.
• Enter all client data into billing system for billing and follow up purposes.
• Prepare and submit bills to the appropriate insurance carriers within forty-eight (48) hours of discharge, for Inpatient bills, and on a minimum of a monthly basis for Outpatient bills.
• Review for Medicare coverage immediately for all over 65 or disabled persons prior to admit.
• Assist the Intake & Referral Department and Outpatient facilities with creating new client files, verifying insurance, pre-certifying admissions, etc. when necessary, or appropriate.
• All new admits, will have ledgers checked for outstanding balances.
• Write off bad debts and alert all necessary departments.
• The employee will ensure that he, or she, is kept up-to-date on all changes in billing procedures, regulatory requirements. In addition, stay up to date with any changes in services at each facility in order that they may be billed properly.
• On a daily basis employee will run appropriate reports to ensure accurate posting of all billing services and payments posted.
• Keep an accurate Accounts Receivable Log of all stats received on a monthly basis.
• Collect, collate and post all charges to the clients ledger.
• Calculate daily room and board for billing and census purposes, and all rendered services in Outpatient as maintained by front desk staff at our OP facilities.
• Compile and submit daily census to Controller for IP, file with Billing Director for OP.
• Performs other duties as assigned.
COMPETENCY REQUIREMENTS:
• Knowledge of Client Ledger Entries.
• Ability to communicate effectively both verbally and in writing.
• Ability to prioritize workload and multitask.
• Ability to work independently.
• Proficient in computer usage, including EMR system, Microsoft Outlook and other information systems.
• EMR documentation.
• Knowledge of managed care networks and insurance carriers.
• Medicaid knowledge.
• Knowledge of collections.
EDUCATION AND QUALIFICATIONS:
Graduation from a recognized High School. Further training in insurance collections or billing helpful. Two plus years of progressively responsible experience working with accounts receivable, collections and insurance billing. Experience with basic computer systems. Possess knowledge of modern office equipment system and procedures. Possess the tact necessary to deal effectively with clients, insurance company representatives and others employees.
PHYSICAL DEMANDS:
The physical demands described here are representative of those functions that must be met by an employee to successfully perform the essential functions of this job.
• While performing this job, the employee is required to talk and hear. Specific vision abilities required by this position include close vision, distance vision and the ability to adjust focus.
• This is a largely sedentary role and involves sitting most of the time. Walking and standing are required occasionally.
• The employee must have the ability to use a computer keyboard, mouse, calculator, copier, fax machine, scanner and telephone.
• This position requires repetitive typing and extensive screen time.
Benefits Available for Full Time Employees:
• Generous Paid Time Off Policy
• Medical, Dental, and Vision Insurance
• Flexible Spending Account
• Basic Group Life AD&D Insurance (No Cost)
• Voluntary Life Insurance
• Other Voluntary Benefits
• Employee Assistance Program
• Retirement Program (401k)
Full Time: Monday-Friday
$17.00- $23.00
#SJ2024
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