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