Key Results Area:
A/R Representative handles large volumes of incoming mail for follow up work attempting to get denied claims paid. This is accomplished by researching into why claims are being denied, reading EOB’s (Explanation of Benefits), and following up with coding department to ensure proper diagnostic codes are being used. This position will be eligible for a hybrid schedule after 90 days of employment.
Principal Duties and Responsibilities:
¨ Work A/R Reports – research into why claims are unpaid, and attempt to receive payment.
¨ Pre-collect report (ensure patient receive appropriate number of billings and verify correct insurance information).
¨ Research all denied claims, read EOBs, determine next steps in order to get claims resubmitted for payment.
¨ Process Trizetto rejections on a daily basis.
¨ Review Customer Service Logs daily and call back customers with answers.
¨ Comply with all aspects of the Compliance Program. Maintains strict confidentiality of all patient information, as well as abides by all Standards of Conduct and HIPAA regulations.
¨ Filing as needed.
¨ After 90 days will answer incoming telephone calls from patients and insurance companies to resolve questions.
¨ Special projects or additional duties as assigned by management.
Education:
High School Diploma and/or equivalent experience required. Associates degree preferred.
Experience:
One-year previous A/R experience required; three years preferred.
Experience calling on insurance companies to check on denied claims.
Ability to read EOBs (Explanation of Benefits) and take appropriate action required.
Required Skills:
Understanding of medical billing concepts and procedures.
Ability to work independently and as part of a team.
Excellent organizational skills and attention to detail.
Must have ability to analyze data and situations and development a range of simple solutions.
Must possess the ability to multi-task a variety of responsibilities.
Must have previous experience working with a high-volume of paperwork.
Ability to read and interpret documents. Ability to write routine correspondence and to speak effectively with management, co-workers and patients.
Ability to operate basic office equipment such as copier, fax, and calculator.
Strong data-entry and 10-key skills. Basic Excel skills.
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- AD&D insurance
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience level:
- 1 year
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
- No nights
- No weekends
Ability to Relocate:
- Saint Louis, MO 63127: Relocate before starting work (Required)
Work Location: Hybrid remote in Saint Louis, MO 63127