ProBill

Accounts Receivable Representative

POSITION SUMMARY

Responsible for communicating and processing insurance requests, denials, and claims for designated payor categories.

DUTIES/RESPONSIBILITIES

1. Comprehensive knowledge of CPT, ICD-9/ICD-10 codes.
2. Research and process insurance denials received electronically and/or by mail.
3. Process rebills, transfers, write-offs as required.
4. Research and resolve insurance and/or payment discrepancies.
5. Process assigned payor category denials.
6. Respond to insurance carrier inquiries.
7. Review outstanding claims on a regular basis.
8. Contact carriers in regard to late payments, incorrect payments and denials.
9. Document patient accounts or by memo to the carrier file.
10. Help with customer service overflow calls.
11. Keep abreast provider updates received from assigned payors.
12. Perform designated tasks that pertain to assigned payors, including documentation of payments received and review of resubmission claims.
13. Prepare and mail appeals to insurance companies as needed for payment.
14. Submit requests for refunds to be processed as needed.
15. Communicate carrier feedback regarding payor requirements or changes as determined by phone and written contact with payors to improve reimbursement coding accuracy and quality.
16. Demonstrate a thorough understanding of hospital guidelines by state as outlined in the Accounts Receivable manual.
17. Maintain confidentiality and adhere to HIPAA regulations.
18. Work as a team to complete daily tasks to meet designated departmental goals.
19. Required to learn other job functions to assist other departments with their goals.

MENTAL/PHYSICAL DEMANDS

1. Ability to identify problems and report issues to manager within a timely manner.
2. Ability to sit for prolonged periods of time to perform repetitious tasks.
3. Ability to analyze and interpret data with minimal supervision.
4. Effective listening and excellent communication skills.

EXPERIENCE/REQUIREMENTS

1. High School Diploma required.
2. Ability to consistently and accurately type 55 wpm.
3. Experienced in the use of personal computers and office automation in a Windows environment and/or other systems and applications as required.
4. One-year experience in medical office, billing/collection functions, or comparable customer service related position required, with at least six months of insurance experience.
5. Previous experience of third-party payors and ICD9/ICD10 codes desirable. 6. Knowledgeable of basic medical terminology.
7. Dependability, flexibility, and teamwork required.
8. Effective organizational and communication skills.
9. Maintain a professional demeanor and positively represent ProBill at all times.
10. Must be comfortable functioning in a collaborative, leadership environment.