A/R Representative ( NE Philadelphia)

Position is responsible for follow up, reviewing and maintaining all patient accounts with third party insurance carriers, ensuring prompt and accurate reimbursement, resolving and processing insurance company denials.
Knowledge of third party professional billing. Three to five years billing experience required. Prior experience with a patient computerized billing system required. Good organizational skills, ability to interact effectively with all levels of personnel, ability to meet timely deadlines, prioritize workload. Up to date knowledge of third party payer rules and regulations. Knowledge of ICD- and CPT-4 coding required. Coding certification preferred . Must know Microsoft Office Excel and Word.

1. Review accounts receivables for all practices sites. Follow up as necessary:
a. Complete paperwork for patient or third party payer refunds
b. Resubmit claims to third party carriers with appropriate modifications.
c. Obtain authorizations from providers to transfer accounts to collection agencies.
d. Review/resolve problematic accounts.
e. Handle patient inquiries regarding unresolved billing issues.
f. Establish budget plans for patients were appropriate.
g. Write off accounts according to Physician Business policies and procedures.
2. Resubmit claims and statements to third party insurance carriers and patients, as necessary.
3. Follow up on rejected or underpaid claims. Initiate claim reviews where appropriate
4. Review claim edit lists for missing or incorrect registration data, diagnostic or procedure codes. Refer edits to practices where appropriate for resolution.
5. Handle billing inquiries form patients, insurance companies and physicians concerning patient accounts
6. Review explanation of benefits received to ensure proper payment from the third party payers.
7. Remain current and knowledgeable regarding all insurer and regulatory changes including those related to Medicare, Medicaid and commercial insurances.
8. Update patient accounts with current insurance coverage as necessary. Coordinate changes with managed care enrollment personnel for capitated patients.
9. Resolves patient billing problems and treats patients with respect at all times. Handles patient correspondence and patient questions as required.
10. Follow up on returned mail. Telephone patients to update registration information. Query hospital database for demographic information.
11. Provide coverage and support to other billing personnel as required.
12. Researches and executed special projects at the request of the Department Administrator.
13. Performs any other responsibilities within the scope of personal qualifications as assigned by supervisory personnel of the effective and economic operation of the department.
14. Maintains confidentiality of work place information according to the policies and procedures of the department.

 

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