Billing and Collections AR
Under the direction of the Business Office Manager and/or Supervisor, the Insurance AR Rep. is responsible for responding promptly to all insurance denials and working the aged collections ledger and enter office charges daily. Responsibilities include coding office visits, rebilling corrected claims, following up on unpaid claims and assisting with any billing when needed. This role requires extensive contact with insurance carriers of all types, as well as clients regarding insurance verification, identification of accounts that have been either under of over paid, and/or resolving open claims in a timely manner. All these practices will be done in a professional and communicative manner, per policies and procedures, guidelines, internal control measures and established goals.
- High School diploma or equivalent required.
- Three years of experience working in a call center environment and/or medical office setting is highly desirable.
- Knowledge of medical coding and/or billing certified is highly desirable
- Knowledge of government regulatory requirements applicable to their role.
- Computer Literate: Excel, Word and PowerPoint are desirable. Gmed/Ggastro knowledge is helpful.
- Responsible for working assigned work queues by insurance and/or patient.
- Follow-up with insurance companies for status on claims.
- Contact patients for payments or other billing information.
- Work with other departments as necessary to resolve issues on accounts.
- Correct and/or appeal denied or rejected claims in EMR System.
- Resolve incorrectly paid claims.
- Evaluating billing/factsheets, outpatient cards, and/or various hospital or procedure records to confirm charges to be billed in a timely fashion.
- Strong knowledge in CPT codes, ICD 10 codes, modifiers, and other general healthcare terminology.
- Collaborate with physicians regarding records and/or charges.
- Transmit all appropriate electronic and paper claims, correct any errors on claims and re-transmit, file secondary claims, as necessary.
- Review claims in unbilled claims to make sure all claims were scrubbed and processed, and no claims need reviewed prior to sending to insurance payer.
- Discuss outstanding payment amounts with patients regarding balance owed by the insurance company and the patient.
- Verify all demographic and insurance information in patient registration of the EMR software system at the time of charge entry to ensure accuracy, provide feedback to clients and supervisor to ensure timely reimbursement.
- Proficiency with all facets of the EMR software system including patient registration, charge entry, insurance processing, advanced collections, reports, and ledger inquiry.
- Adhere to all practice policies related to HIPAA and Medicare Compliance.
- Answer calls from Billing Que to review patients account or give benefits for procedures or upcoming appointments.
- Other duties as requested.