Medical Accounts Receivable Representative

Position Summary / Scope of Responsibility:

The Centers for Advanced Orthopaedics LLC (CAO) is one of the nations largest Orthopaedics practices, owned and operated by physicians, with over 60 locations across Maryland, Northern Virginia, and the District of Columbia. With approximately 2,000 employees, working in 28 Divisions, CAO is a growing business with revenues of approximately $250 Million. CAO is committed to be the Orthopaedics provider of choice for our patients; partner of choice for payors and health systems; and employer of choice by attracting and retaining a talented workforce.

The Central Billing Office (CBO) Accounts Receivable Representative is responsible for performing a variety of complex Accounts Receivable-related functions for the Central Billing Office.

Primary Responsibilities:

The incumbent may be asked to perform job-related tasks other than those specifically stated in this description. The duties and responsibilities of the position are to be carried out in a manner that is consistent with the Mission, Core Values and Operating Principles of CAO.

• Investigates and resolves denied claims.
• Works and manages claims from all aging buckets, including posting, appeals, ADRs.
• Identifies and reviews delinquent accounts and pursues collection as needed.
• Performs and documents follow-through efforts in a timely manner.
• Coordinates medical record documentation to be submitted with appeals.
• Communicates accurate patient and billing information to insurance carriers.
• Prepares weekly status reports for review with management.
• Assists with medical biller duties, including but not limited to handling insurance claims, submitting claims to insurance, collecting, posting, and managing patient account payments, and preparing and reviewing patient statements.

Reporting Relationships:

The CBO Accounts Receivable Representative reports directly to the designated Central Billing Office leader. The role currently does not have any direct reports.

Requirements, Education and Experience:

1. High school diploma
2. 2+ years of related experience, with experience in an orthopaedic setting preferred
3. Proficiency with Microsoft Office suite of products as well as electronic billing systems
4. Extensive knowledge of insurance, benefits, medical terminology, and medical billing
5. Experience working with billing and Accounts Receivable for both commercial and non-commercial payors

Competencies / Required Skills and Abilities:

1. Strong Interpersonal Skills - Ability to develop relationships and collaborate and influence in a decentralized organization.
2. Demonstrated ability to organize, prioritize, and manage multiple tasks in a dynamic environment with a proven track record of results.
3. Strong interpersonal, oral, and written communication skills with excellent self-discipline and patience.
4. Able to work independently.
5. Exudes professionalism in presentation.
6. Must be able to read, write, speak, understand, and communicate in the English language.