Job description

Raleigh,NC - USA

Position Requirements

Under the direct supervision of the Collections Supervisor or Manger, the Accounts Receivable Representative III is responsible for effective and efficient accounts receivable management of assigned payers. Collections efforts on outstanding accounts include telephone contact with payers, work collection reports and correspondence, audit accounts, appeal denied claims as necessary, update accounts as necessary, identify carrier related denial trends and meet departmental productivity standards. Accounts Receivable Representative III will also coordinate the transfer of patient responsibility and work accounts that require additional insurance collection follow-up.

Principal Duties and Responsibilities

Reviews, evaluates, and forwards manual paper claims to payers that do not accept electronic claims or that require special handling
Document’s billing activity on the patient account; ensures compliance with all applicable billing regulations and reports any suspected compliance issues to departmental leaders
Reviews claims for accuracy and coordinates with ancillary departments as needed to provide information for audits and/or record reviews
Based on electronic payers’ error reports, makes appropriate corrections to optimize the electronic claims submission process
Pursues prompt follow-up efforts on aged accounts, which may involve helping to formulate written appeals
Accurately documents all follow up on the account to ensure there is an accurate record of the steps taken to collect on an account.
Monitors claim rejections for trends and issues; reports these findings to the lead biller and other departmental leaders
Practices excellent customer service skills by answering patient and third-party questions and/or addressing billing concerns in a timely and professional manner
Assists in reviewing and/or resolving credit balances
Participates in general or special assignments and attends required training

The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and should not be considered a detailed description of all the work requirements that may be inherent to the position.

Position Qualifications

Education:

High school diploma or equivalent certification required
Associate degree preferred

Experience:

3 to 5 years of customer service and/or business office experience preferred in a medical setting
Knowledge of basic patient accounting processes and healthcare terminology strongly preferred

Knowledge, Skills, Abilities:

Strong computer skills (including MS Word and Excel)
Ability to maintain accuracy while working on multiple tasks in a fast-paced environment under low-to moderate supervision
Excellent verbal and written communication skills, including professional telephone etiquette
Ability to ensure confidentiality of sensitive information and maintain HIPAA compliance
Dependable in both production and attendance
Exceptional organization and time management skills

Total Rewards