A/R Follow Up Representative- Healthcare- WEST COAST CANDIDATES ONLY

Job description

**This position is supporting West Coast clients so we prefer PST. applicants.**

The Accounts Receivable Representative is responsible for the follow-up on identified government and non-government claims including Medicare /Medicaid and Government HMO. The incumbent will resolve unpaid accounts in a timely and efficient manner for one or more geographical areas, while maintaining quality and productivity standards set for the Level 1 A/R Follow-up Representative.

Requirements:

• Review eligibility, verify insurance benefits, and/or perform insurance discovery activities required to generate a clean claim.
• Review, modify as necessary, and re-bill rejected/denied claims in “queue” by assigning appropriate insurance carrier, utilizing the billing address and/or payor prefix.
• Process “queues” within appropriate timeframes, (e.g. claims status checks, appeals of denied claims).
• Recode claims, assigning proper condition codes/ICD-9 codes/procedure codes into the Accounts Receivable Billing System and re-file claims as necessary.
• Update appropriate modifiers, based on origin and destination of trip and change insurance claims as necessary.
• Create narrative in the Accounts Receivable Billing System to document status of trip for use in claim appeal process.
• Other duties as assigned.
• Work in a spirit of teamwork and cooperation.
• Convey a sense of competence and commitment.
• Use initiative to learn new skills, enhance personal knowledge and improve communications.
• Demonstrate an ability to work well with team members.
• Communicate a willingness to help others succeed.

Qualifications:

• High School Diploma or GED required, Associates Degree or certificate of completion from a coding and billing school preferred. Examples: Certifications
• Minimum one (1) year previous medical billing experience required; ambulance billing experience preferred.
• Medical transportation processes.
• Terminology on a PCR, Hospital Face Sheet, and/or a CAD Sheet.
• Process of signature and paperwork compliance.
• Payor-specific requirements for one or more geographical areas and/or financial classes.
• Distinctions between ALS/BLS/SCT/Gurney/Wheelchair/CCT levels of service.
• ICD-9 coding/condition codes and procedure codes.
• Government coverage guidelines, filing limits and necessary prior authorizations.
• Medical terminology and insurance terminology.
• Internal Compliance guidelines.
• Appeal levels and the redetermination process.
• HIPAA requirements.
• Proficient in the Accounts Receivable Billing System and Internet, (e.g. Internet mapping programs, eligibility websites, address search engines).
• Basic understanding of Microsoft Word and Excel.
• Communicate effectively, (both orally and in writing) in English.

Benefits

Integra Connect, LLC provides a comprehensive benefits plan.

• Medical/Dental/Vision Insurance beginning the 1st of the month following your date of hire
• Paid Time Off
• 401k with employer match
• Paid Holidays and Floating Holiday

Equal Opportunity Employer

Please note that the deadline for submitting applications is March 31, 2024. All applications must be received by this date to be considered.

Job Type: Full-time

Pay: $16.00 - $23.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work setting:

• Remote

Work Location: Remote