Responsibilities

• Complete monitoring and resolving claim denials and/or low insurance payments.
• Work the aging accounts and collect pending receivable payments from insurance companies.
• Prioritize and effectively communicate.
• Work with the team to achieve and maintain key AR benchmarks.
• Meet Productivity Goals.
• Regularly review accounts and prepare information for the collection agency, correcting and resubmitting claims to third-party payers when necessary.
• Check each insurance payment for accuracy, including contract-discount compliance.
• Review patient bills for accuracy and obtain missing information before identifying and billing secondary and tertiary insurances.
• Call insurance companies to settle payment discrepancies or investigate unpaid claims within the standard billing cycle timeframe.
• Research and resolve accounts.
• Provide additional education back to team members on Member specifics or payer guidelines.
• Adhere to all HIPAA guidelines and regulations keeping all of the data in our system safe and secure.
• Reliable and punctual in reporting for work and taking designated breaks.

Abilities and Knowledge

• Making decisions, problem solving, and a knack for finding solutions are key in this role.
• Ability to resolve payment issues and effectively follow up with insurance companies.
• Knowledge of insurance guidelines, especially those associated with Medicare and Medicaid as well as ICD-10 and CPT codes.
• Critical and analytical thinking skills to help resolve billing issues and collect payments.
• Top-notch confidentiality in accordance with Data Privacy Policy.
• Be passionate about quality.
• Be able to perform in all forms of communication (i.e., phone and email). You’ll be interacting with insurance companies regarding accounts, past due balances, unpaid claims, and other billing-related items. Strong communication skills are a must. 
• Be fluent in billing language and comfortable with AR software.
• Meet weekly metrics by working the required number of accounts per day, which includes working denials, sending appeals, communication with our members and patients.

Education and Experience

Required:

• One to Two years of experience in AR 
• At least Graduate 
• Healthcare compliance and terminology knowledge