Accounts Receivable Representative Medical

$45,760 - $49,920/Yr

Shared Response Health Systems - Killingworth, CT

Part-time - Entry Level

Killingworth, CT

Professional, Scientific, and Technical Services

About the position

The Accounts Receivable Representative at Shared Response Health Systems is responsible for managing the accounts receivable process, focusing on reviewing denials, submitting appeals, and ensuring timely reimbursements from commercial insurance carriers. This role requires a strong understanding of insurance policies and excellent communication skills to effectively represent the practice.

Responsibilities

• Review and analyze denied claims to identify reasons for denial.
• Prepare and submit appeals to insurance carriers to secure reimbursement.
• Conduct follow up on outstanding self-pay accounts.
• Utilize in-depth knowledge of commercial insurances, including Aetna, Anthem BCBS, Cigna, and UHC, to effectively navigate denial trends and policies.
• Monitor and manage aging reports, focusing on claims that are 30, 60, and 90 days old to recoup outstanding reimbursements.
• Develop strategies to reduce aging claims and improve cash flow.
• Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to identify patterns and trends in claim denials.
• Document findings and make recommendations for process improvements.
• Conduct thorough research on insurance policies and guidelines relevant to appeals.
• Maintain organized documentation of all billing activities and correspondence related to claims.
• Communicate professionally and effectively with patients, vendors, and insurance carriers, representing the practice's values and standards.
• Address inquiries and provide updates regarding claims status to stakeholders.
• Work collaboratively with the billing team to support overall revenue cycle management.
• Knowledge of medical coding, including DRG, CPT, ICD-9, and ICD-10.
• Proven experience in medical collections and medical office environments.

Requirements

• Medical office experience: 1 year (Required)
• ICD-10: 1 year (Required)
• Strong communication skills
• Knowledge of medical coding including DRG, CPT, ICD-9, and ICD-10