Accounts Receivable Representative

JOB SUMMARY

The Accounts Receivable Representative for Value-Based RCM, Inc. (VBRCM) is responsible for resolving payer insurance denials as a third-party, identifying trends and payer requirements, to prevent future denials.

MAJOR AREAS OF FOCUS

· Denial Resolution

· Process Improvement (Continuous Mitigation)

· Payer Rules and Regulations

RESPONSIBILITIES

· Identify payment and denial trends and communicate to Supervisor and/or Team Lead

· Perform necessary follow-up to ensure timely resolution of appeals, obtain updated insurance information, identify, and correct billing errors, etc.

· Independently identify and communicate (verbal/written) denial reasons and steps towards resolution

· Handle client, payer, and patient inquiries in a timely and detailed manner

· Maintain working knowledge of current Medicare, Medicaid, and third-party billing, claim form, and appeal requirements.

· Maintain current working knowledge of CPT and ICD-10 codes, required modifiers and encounter data, Explanation of Benefits (EOB) reason and remark codes

· Preserve accurate and timely notes in billing system(s), ensuring a clear understanding of the activity transpired

· Utilize payer web sites and /or portals

· Meet department productivity and quality standards

· Exhibit professional behavior and communication skills representative of VBRCM's commitment to superior customer service

· Use, protect, and disclose patient protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

· Perform other duties as assigned

KNOWLEDGE AND SKILLS

· Excellent problem solving and communication skills

· Working knowledge of CPT and ICD-10

· Ability to work independently and as part of a team

· Working knowledge of medical terminology preferred

· Strong computer, typing and calculator skills

· Ability and desire to work in a remote environment

· Strong organizational skills and attention to detail

EDUCATION/EXPERIENCE

· High school diploma or GED

· Previous medical billing experience required

· Proficient in Microsoft office (Excel, Word, and PowerPoint)

PHYSICAL REQUIREMENTS

· Prolonged periods sitting at a desk and working on a computer

· Must be able to lift up to 15 pounds at times

JOB TYPE: Full-time

HOURLY RATE: $19 - $24 per hour

JOB LOCATION

· Remote

BENEFITS:

· Paid time off

· Work from home

· Company-sponsored medical, dental, and vision insurance

SCHEDULE:

· Monday to Friday