Medical Account Receivable Representative

• Telephone insurance carrier/patient to seek resolution on account

• Resolve inappropriate payments with insurance carriers that are not in compliance with payer contracts or governmental agency rates on individual accounts

• Utilize specialized knowledge of contracts, regulatory or contractual billings guidelines to determine an account’s ability to pay after initial rejection from payer

• Coordinate duplicate billings, coordination of benefits, medical records or clinical documents as needed to expedite payment of insurance claims

• Identify trends in payer non-compliance and inform management if not able to resolve with payer

• Negotiate within specified guidelines with payers

• Ensure secondary carrier is appropriately billed or self-pay portion is pursued

• Determine an individual’s ability to pay and seeks additional assistance either through governmental programs or uncompensated care programs

• Follows up with appropriate staff to locate missing information

• Ensure accurate and timely billing of all outstanding account balances to the appropriate third party payers and patient guarantors

• Maintain necessary logs

• Answer telephone calls as needed

• Assist with the planning and organization of departmental activities as needed and participate in said activities

• Participate in departmental meetings as necessary.

• Requirements: