Accounts Receivable Representative

$65,770 - $65,770/Yr

HSS - New York, NY

Full-time - Entry Level

New York, NY

Hospitals

About the position

The Accounts Receivable Representative at the Hospital for Special Surgery (HSS) plays a crucial role in the billing office, focusing on the management of denied claims and follow-ups with insurance companies regarding unpaid claims. This position is essential in ensuring that the hospital collects the money payable for services provided to patients. The representative will be responsible for reviewing and processing correspondence from both patients and insurance carriers, ensuring that all claims are addressed efficiently and effectively. In this role, the Accounts Receivable Representative will engage in various primary functions, including insurance follow-up for primary, secondary, and tertiary claims. They will also manage denial cases, which involves understanding payer denials and developing solutions to address these issues. The representative will be tasked with submitting appeals to insurance carriers for reasons such as medical necessity and bundling, which requires a solid understanding of medical billing practices. Additionally, the representative will handle credit balance management, which includes reviewing and resolving payment application errors. They will maintain unbilled charge reports, denial reports, and claim allocation reports, ensuring that all patient accounts are accurately annotated with adjustments and updates. The role may also involve performing other related duties as required by the A/R Manager, to whom the representative will report directly. This position is ideal for individuals who are detail-oriented and possess strong computer skills, particularly in Microsoft Office and Excel, along with a foundational knowledge of medical coding.

Responsibilities

• Review and process correspondence from patients and insurance carriers.
• Follow up with primary, secondary, and tertiary claims.
• Manage denial cases, including payer denials and denial solutions.
• Submit appeals to carriers for reasons such as medical necessity and bundling.
• Manage credit balances by reviewing and resolving payment application errors.
• Maintain unbilled charge reports, denial reports, and claim allocation reports.
• Annotate adjustments and updates to patient accounts.
• Perform other related duties as required.

Requirements

• High School Diploma or equivalent, with some college preferred.
• Minimum of three years experience in medical billing procedures including registration, charge entry, and claim preparation.
• Computer skills and knowledge of relevant software (Microsoft Office and Excel).
• Knowledge of medical coding is a plus.