Job Description
Job description
The Accounts Receivable Representative is responsible for the follow-up on identified government and non-government claims including Medicare /Medicaid and Government HMO. The incumbent will resolve unpaid accounts in a timely and efficient manner for one or more geographical areas, while maintaining quality and productivity standards set for the Level 1 A/R Follow-up Representative.
Responsibilities:
Β Review eligibility, verify insurance benefits, and/or perform insurance discovery activities required to generate a clean claim.
Β Review, modify as necessary, and re-bill rejected/denied claims in ΒqueueΒ by assigning appropriate insurance carrier, utilizing the billing address and/or payor prefix.
Β Process ΒqueuesΒ within appropriate timeframes, (e.g. claims status checks, appeals of denied claims).
Β Recode claims, assigning proper condition codes/ICD-9 codes/procedure codes into the Accounts Receivable Billing System and re-file claims as necessary.
Β Update appropriate modifiers, based on origin and destination of trip and change insurance claims as necessary.
Β Create narrative in the Accounts Receivable Billing System to document status of trip for use in claim appeal process.
Β Other duties as assigned.
Β Work in a spirit of teamwork and cooperation.
Β Convey a sense of competence and commitment.
Β Use initiative to learn new skills, enhance personal knowledge and improve communications.
Β Demonstrate an ability to work well with team members.
Β Communicate a willingness to help others succeed.
Β Share workspace and resources as necessary.
Qualifications:
Β High School Diploma or GED required, Associates Degree or certificate of completion from a coding and billing school preferred. Examples: Certifications
Β Minimum one (1) year previous medical billing experience required; ambulance billing experience preferred.
Β Medical transportation processes.
Β Terminology on a PCR, Hospital Face Sheet, and/or a CAD Sheet.
Β Process of signature and paperwork compliance.
Β Payor-specific requirements for one or more geographical areas and/or financial classes.
Β Distinctions between ALS/BLS/SCT/Gurney/Wheelchair/CCT levels of service.
Β ICD-9 coding/condition codes and procedure codes.
Β Government coverage guidelines, filing limits and necessary prior authorizations.
Β Medical terminology and insurance terminology.
Β Internal Compliance guidelines.
Β Appeal levels and the redetermination process.
Β HIPAA requirements.
Β Proficient in the Accounts Receivable Billing System and Internet, (e.g. Internet mapping programs, eligibility websites, address search engines).
Β Basic understanding of Microsoft Word and Excel.
Β Communicate effectively, (both orally and in writing) in English.
Benefits
Integra Connect, LLC provides a comprehensive benefits plan.
Β Medical/Dental/Vision Insurance beginning the 1st of the month following your date of hire
Β Paid Time Off
Β 401k with employer match
Β Paid Holidays and Floating Holiday
Equal Opportunity Employer
Job Type: Full-time
Benefits:
Β 401(k)
Β 401(k) matching
Β Dental insurance
Β Employee assistance program
Β Health insurance
Β Life insurance
Β Paid time off
Β Vision insurance
Schedule:
Β Monday to Friday
Work Location: Remote
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