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
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
- Work from home
Schedule:
- Monday to Friday
Work setting:
- Remote
Work Location: Remote