AR Follow Up Representative - Occupational Health & Workers Comp exp. pref

Job Purpose

The AR Follow Up Representative is responsible for completing tasks associated with specific assignments. Specific job responsibilities will be collections, account follow up, billing and allowance posting for the accounts assigned to them. Accounts Receivable Representative I is expected to perform assignment tasks within the quality and productivity standards assigned to position responsibilities.  

Duties and Responsibilities

• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites.
• Meets and maintains daily productivity/quality standards established in departmental policies. 
• Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts. 
• Adheres to the policies and procedures established for the client/team. 
• Knowledge of timely filing deadlines for each designated payer.
• Performs research regarding payer specific billing guidelines as needed. 
• Ability to analyze, identify and resolve issues causing payer payment delays. 
• Ability to analyze, identify and trend claims issues to proactively reduce denials.
• Communicates to management any issues and/or trends identified. 
• Initiate appeals when necessary. 
• Ability to identify and correct medical billing errors.
• Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process.
• Understanding of under or over payments and credit balance processes.
• Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required. 
• Act cooperatively and courteously with patients, visitors, co-workers, management and clients.
• Work independently from assigned work queues.
• Maintain confidentiality at all times.
• Maintain a professional attitude. 
• Other duties as assigned by the management team. 
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Qualifications

• Preferred 1-5 years’ experience in insurance collections, including submitting and following up on claims for a Medical Practice, Medical Facility/Medical Billing Company, Ambulatory Surgical Center, and/or Hospital or equivalent work experience.
• Preferred Physician/Professional Billing: 1 year or equivalent work experience.
• Basic functioning knowledge of the denied claims and appeals process
• Basic functioning knowledge of Worker’s Comp and PIP preferred
• Basic functioning knowledge of individual payor websites, including, but not limited to, Navinet, Availity and the respective Blue Cross Blue Shield, Medicare and Medicaid sites depending upon the state/s in which the client is located. 
• Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes 
• Ability to work well individually and in a team environment
• MS Office basic skills. Must have basic Excel skillset 
• Experience with practice management systems. Preferably EPIC PB, Centricity, Allscripts and/or Cerner
• Strong communication skills/oral and written 
• Strong organizational skills 

Working Conditions

• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. 
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.