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Job details

Biller/AR Follow Up Representative

Overview:

The biller and AR follow up rep requires someone with expertise on working rejections/AR follow up/resolving denials and with working knowledge on MediTech .

Responsibilities:

Team player with excellent organization, communication, and written skills
Proficiency in Microsoft Office, including Excel and Word
Basic math and typing skills
Understands the critical delineations of patient status (outpatient, inpatient, and observation) based on payor regulations.
Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites

Understanding of government, Medicare and Medicaid claims
Review and updates all patient and financial information accurately as given
Verifies that information is accurate as to individual or insurance company responsible for payment of bill
Monitors all billings for accuracy, updating any that contain known errors
Monitors Medicaid/healthy options coupons to assure services are billed within expected timeframes
Bills all hospital services to primary insurer or patient correctly and within expected timeframe
Follows up with insurance companies on all assigned accounts within expected timeframe
Explains hospital regulations with regard to methods for payment of accounts and maintains complete working knowledge of insurance regulations and hospital insurance contracts
Identify and report underpayments and denial trends
Ability to analyze, identify and resolve issues causing payer payment delays Initiate appeals when necessary
Basic knowledge of healthcare claims processing including: ICD-9/10, CPT and HCPC codes, as well as UB-04
Ability to manipulate excel spreadsheets and communicate results

Communicate professionally and timely with internal and external customers.
Provide helpful assistance in anticipating and responding to the needs of our customers.

Qualifications:

EDUCATION/EXPERIENCE REQUIRED

2-5 years of experience in the Healthcare Revenue Cycle that includes working rejections/AR follow up/resolving denials and with working knowledge on MediTech
CPC Coding Certification preferred
Knowledge of CPT and ICD coding
Knowledge of Medicare and third-party payer regulations and guideline

KNOWLEDGE, SKILLS, AND ABILITIES

Requires someone with expertise on working rejections/AR follow up/resolving denials and with working knowledge on MediTech
Hospital/Facility billing experience
2-3 years of hands-on experience in insurance collections, with expertise in claims submission and follow-up
Solid understanding and knowledge of payer contractual requirements, registration workflows, and prior authorization requirements to maximize reimbursement and minimize write-offs.
Maintains current knowledge of medical modalities as well as new protocols established for patient populations.
Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
Basic understanding of human anatomy, specifically musculoskeletal and neurology
Proficient use of CPT and ICD-10 codes
Able to meet productivity with 10 authorizations per hour with 95% accuracy.
Excellent computer skills including Excel, Word, and Internet use.
Detail oriented with above-average organizational skills.
Excellent customer service skills; communicates clearly and effectively
Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
Willingly accept feedback.
Ability to problem-solve and work independently.
Dependable and reliable in achieving goals.
Familiarity with medical terminology and abbreviations

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CEO of GeBBS Healthcare Solutions

Milind Godbole

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By GeBBS Healthcare Solutions

Partnering with clients to help them achieve their strategic business objectives by deploying business impacting solutions with passion, excellence and speed of execution.

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INDUSTRY

Health Care Services & Hospitals

TEAM SIZE

10000+

LOCATION

Hybrid, based in Los Angeles, India

DATE POSTED

August 6, 2023