A/R Representative 2
Prestige Staffing is hiring for an A/R Representative 2 for a Monday through Friday position with flexible start times for a full 40 hour work week. This is a temp-to-perm opportunity for the ideal candidates.
The A/R Representative position is responsible for a variety of functions: intake of new placements for stat using and next follow up, follow-up of accounts receivable inventory for cash collections and account resolution, processing and reporting of allowances and adjustments. These functions include, but are not limited to, the cash and denial application of assigned third party accounts. Additional responsibilities may include billing accounts to the payer via electronic or paper, both primary and secondary claims. This position requires the ability to work with both hospital and physician accounts as well as with both debit and credit inventory.
- Requires comprehensive knowledge of medical collections within a hospital or physician setting for 2 or more years.
- Some college preferred; coding/billing certifications STRONGLY preferred.
- CRCS certification considered a PLUS for more advanced level opportunities.
Strong background of medical billing and follow up with over 2 year experience in the field
- Strong knowledge of Third Party Payers (governmental, non-governmental, workers compensation, commercial and managed care).
- Strong knowledge of HCPCS/CPT/ICD10 and Medical Terminology as it pertains to reimbursement methodology.
- Strong comprehension of EOB’s and UB/HCFA forms and how they are used in relation to medical billing and follow up. Understanding of financial class assignments, charges, payments, allowances and adjustments.
- Strong analytical and problem solving skills.
- Self-motivated with proven record of working independently as well as in a team in a fast paced, customer service environment.
- Well organized and able to prioritize projects and deadlines, quality and productivity; basic multi-tasking skills. Able to handle more than 1 project within a week.
- Strong oral and written communication skills.
- Good customer service skills with sensitivity, sound judgment and courteous phone manner.
- Able to be flexible and adaptable to change.
- High energy; productive work habits.
- Proficiency in MS Office applications including Word, Excel and Outlook.
- Proven ability to identify, escalate, track and trend denials.
- Ability to work high dollar accounts over $2K, Government Managed Care programs, more advanced Worker’s Compensation claims, MVA accounts and Governmental plans.
- Ability and dependability in following directives: experience with contract interpretations, EOB analysis and industry related forms and procedures and industry websites.
- Reliable and maintains good attendance and punctuality
- Advanced customer service skills including empathy, sensitivity to issues, and resolution of patient complaints regarding insurance disputes and denials
- Ability to bill accounts, work pre-authorizations, claim edits, registration and scheduling queues and appeal administrative denials
- Triage new placements from intake status to follow up status based on client notes, EOB’s or billing actions provided on the account. Ensure notes are detailed and the next status and follow up date will ensure the account moves through the resolution process
- Manage inventory assigned via work queues or work lists and ensure proper follow up is performed on the accounts for cash resolution. If cash resolution is not deemed viable, provide documentation to support the need for an adjustment or patient liability transfer
- Contact insurance carriers on a daily basis for claim status as assigned either by phone or website; determine reason for the lack of payment or underpayment and work to resolve the account for cash collections
- Handle all telephone calls in an efficient manner by maintaining clear and concise communication with callers and deliver accurate information on the status of the account.
- Follow-up on internal and external requests accurately and expeditiously to process information and resolve issues. All management and client requests are responded to in less than 24 hours. All payers and outside requests are responded to in less than 48 hours.
- Regularly advise Supervisor and Operations Director of any issues with systems, inventory or payers. Provide consistent knowledge transfer on your inventory to ensure that trends and payer issues are addressed and the client is aware of on-going issues that may be affecting their inventory.
- Respond to directives and assignments in a timely manner while conveying professionalism and cooperation during interactions with co-workers, provider representatives, clients and the like.
- Achieve and consistently maintain daily, weekly and monthly productivity and quality goals as determined by department needs and standards.
- Document the system with clear, concise, complete and accurate language to include proper status codes and universal abbreviations; ensure effective and timely handling of claims.
- Review documentation in client system, prior notes, EOB’s, and correspondence and provide action. Update incorrect insurance information in client system, transfer balances to patient or other insurance, rebill, contact patient for updated information, follow up with insurance carrier as applicable
- Participate in meetings to build cohesive team by responding to inquiries, making recommendations, sharing observations and respecting other team members’ input.
- Maintain an overall understanding of all applicable computer software applications to perform job duties accurately and efficiently. Microsoft Outlook, Client Systems (patient accounting and billing)
- Demonstrate an understanding of security and confidentiality of data and information as required for Compliance.
- Utilize tools and resources as directed.
- Represent and promote the Company and its high standards.
- Show willingness to enhance skill sets and accept cross training to meet global corporate needs.
- Comprehensive and working knowledge of EOB, UB, HCFA, HCPCS, ICD10, Revenue Codes and related forms for Managed Care, Commercial, Workers Compensation and Governmental contracts.
- Ability to work both hospital and physician inventory as well as debit and credit balances
- Ability to multitask between company work queues and client systems
- Ability to work in client work queues for authorization, registration, referral, claim edit and scheduling
- Ability to work reconciliation reports as guided by management to determine and resolve why an account between the client system is not synced with the company system
Supervisory Responsibility -This position has no supervisory responsibilities.
Apply today for immediate consideration for employment with this wonderful organization.