AR Representative

Penn Medicine - Philadelphia, PA

Full-time

Philadelphia, PA

Ambulatory Health Care Services

About the position

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. The Accounts Receivable (AR) Representative plays a crucial role in facilitating maximized revenue for the practice by managing strategies to collect payments from third-party payers. This position is integral to supporting the practice manager and providers in maintaining a patient/customer focus, ensuring the delivery of the highest quality care, and assisting in meeting or exceeding patient satisfaction and financial and operational targets. The AR Representative is responsible for efficiently managing Accounts Receivable using established work queues and process flows, meeting established productivity metrics. This role requires proactive collaboration with co-workers to collect on monies due as part of patient responsibility and, when necessary, working directly with patients to develop payment plans. The representative will also identify and track third-party rejection types to determine patterns, monitor changes to reimbursement policies, and inform or recommend changes to billing policies as needed. In addition, the AR Representative will review, process, and challenge all rejections and denials, escalating notable trends to the Practice Manager. They will identify issues related to timely filing and communicate appropriately, process charge files, and manage charge review, claim edit, and credit work queues within designated benchmarks. Regular meetings with the Manager will be held to review the status of Accounts Receivable, special projects, and problematic accounts, with a focus on identifying areas for improvement. The representative will also attend required training sessions to maintain knowledge of necessary systems and respond efficiently to questions and requests within established timeframes. Overall, this position is vital in supporting the unit, department, entity, and health system organization.

Responsibilities

• Efficiently and effectively manages Accounts Receivable using established workqueues and process flows.
• Proactively works with co-workers to collect on monies due as part of patient responsibility.
• Works with patients to develop payment plans as needed.
• Identifies and tracks third party rejection types to determine rejection patterns.
• Facilitates maximized revenue for the practice by managing strategies to collect monies from third party payers.
• Monitors changes to third party reimbursement policies and billing procedures.
• Informs and/or recommends changes to billing policies.
• Reviews, processes and challenges all rejections and denials, escalating notable trends to the Practice Manager.
• Identifies issues related to timely filing and communicates appropriately.
• Processes charge files and appends necessary data.
• Manages charge review, claim edit and credit workqueues within the designated benchmark.
• Meets regularly with Manager to review status of A/R, special projects, and problematic or unusual accounts.
• Reviews Indicator and Productivity metrics with manager and identifies areas for improvement.
• Manages special projects related to AR as assigned.
• Attends all required training sessions and maintains knowledge of systems required for the position.
• Responds to questions, requests, and support calls efficiently and professionally.
• Works effectively to meet project and assignment deadlines.
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures.

Requirements

• H.S. Diploma/GED and 4+ years of experience working within medical office environments (Required).
• 1+ years of experience in physician billing responsibilities or accounts receivable management strongly preferred (Preferred).
• Bachelor's Degree in business, accounting, or healthcare administration preferred.
• Coursework in medical terminology preferred.
• Experience in the insurance/HMO industry or academic medical center strongly preferred.

Nice-to-haves

• Experience in the insurance/HMO industry or academic medical center strongly preferred.

Benefits

• Comprehensive compensation and benefits program.
• Prepaid tuition assistance programs.
• Health and wellness programs for employees.