Job description

Scope:

The Accounts Receivable Representative in our Revenue Cycle Management (RCM) department, is responsible for claim resolution and payment. They will work insurance claims and patient accounts using department guidelines and MPG/PFP electronic systems. The position requires a thorough knowledge of insurance carrier billing and reimbursement, CPT, modifiers, and fee schedule differences. This requires understanding of how to decipher explanation of benefits and explain the impact to the customer. The position requires the ability to conduct both telephone and face to face meetings with patients regarding account resolution and payment collection. Expert verbal communication, interpersonal skills and professional appearance required for dealing with customers both internal and external. Additional duties as required.

Specific Responsibilities of the Job:

• Effectively resolves unpaid, denied, appeals or overpaid claims while utilizing carrier websites and automated inquiry systems to minimize phone/non-productive time.
• Supports the Customer Service Team as needed
• Meet timelines for Athena claims follow up
• Demonstrates interpersonal skills with patients, co-workers, and insurance carriers
• Advanced knowledge of CPT, ICD-10, and modifiers
• Correspondence & voicemails returned within 1 business day
• Claim adjudication carrier rules knowledge are current and meets/exceeds monthly performance goals, expectation, and reviews.
• Monitors denials for potential trends and effectively communicate these issues with management.
• Uses PTO effectively
• Keeps Overtime to a minimum / has any overtime approved by manager.
• Actively participates in team meetings and educational opportunities
• Conducts themselves in accordance with MPG/PFP Policies and Procedures including the Code of Conduct

Skills and Abilities:

• Understand payer/insurance structure
• Ability to read and fully understand an EOB (Explanation of Benefits)
• Understanding adjustments (write-off) amounts
• Ability to understand difference between non-covered services and covered services
• Ability to differentiate between Copay/Deductible and no patient responsibilities

Qualifications:

• High School diploma, GED or suitable equivalent
• 2+ years’ experience in Healthcare Insurance accounts receivable, Family Medicine experience preferred
• Athena EMR experience preferred
• Excellent verbal and written communication skills, including but not limited to email and telephone etiquette
• Proficient with MS Office and Excel

Benefits:

• Competitive benefits offering including Medical, Dental, Vision, 401K Match, Life Insurance & PTO
• Health Savings Account option
• Position may be remote after 2 weeks of training hours 8 – 5 pm Monday - Friday

Reports to: Revenue Cycle Manager

Job Type: Full-time

Pay: $16.00 - $20.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• High school or equivalent (Required)

Experience:

• Accounts receivable: 1 year (Preferred)
• Microsoft Office: 1 year (Preferred)

Work Location: Hybrid remote in Austin, TX 78746

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