Job Description

JOB PURPOSE

Supports management team with the coordination of activities and operations of AR Follow up department

DUTIES AND RESPONSIBILITIES

• Assist AR representative team members by answering questions and providing support for their ongoing success

• Provide initial training on the client host system

• Assist and support AR follow up representatives with research on A/R related projects

• Assist in tracking productivity and quality of AR Representatives

• Identify areas of opportunity for improvement through one on one evaluation of AR Representative team

• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites

• Meets and maintains daily productivity/quality standards established in departmental policies and supports training needs identified to ensure teams success in this area

• Meets and maintains quality standards established in departmental policies and supports training needs identified to ensure the teams success in this area

• Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts

• Adheres to the policies and procedures established for the client/team

• Knowledge of timely filing deadlines for each designated payer

• Initiate appeals when necessary

• Ability to identify and correct medical billing errors

• Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process

• Ability to analyze, identify and resolve issues causing payer payment delays

• Ability to analyze, identify and trend claims issues to proactively reduce denials

• Understanding of under payments and credit balance process

• Perform special projects and other duties as needed. Assists with special projects by utilizing excel spreadsheets, and the ability to communicate results

• Act cooperatively and courteously with patients, visitors, co-workers, management and clients

• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

• Work independently from assigned work queues

• Maintain confidentiality at all times

• Maintain a professional attitude

• Other duties as assigned by the management team

QUALIFICATIONS

• Experience in insurance collections, including submitting and following up on claims for a Medical Practice, Medical Facility/Medical Billing Company, Ambulatory Surgical Center, and/or Hospital

• Experience with the Client’s host system.

• Experience with training new users

• Physician/Professional Billing:

• Knowledge of the denied claims and appeals process

• Extensive knowledge of individual payor websites, including Navinet and Novitasphere

• Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes

• Ability to work well individually and in a team environment

• Proficiency with MS Office. Must have basic Excel skillset

• Experience with practice management systems. EPIC PB, Allscripts and/or Cerner preferred

• Strong communication skills/oral and written

• Strong organizational skills

WORKING CONDITIONS

General Office Environment

• While performing the duties of the job, the employee is occasionally required to move around the work area
• Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear
• The employee must be able to follow directions, get along with others and handle stress
• The noise level in the work environment is usually minimal

Med-Metrix is an Equal Opportunity Employer committed to excellence through diversity. Employment offers are made on the basis of qualifications, and without regard to age, race, color, religion, gender, national origin, ancestry, citizenship status, marital status, familial status, sexual orientation, gender identity, expunged juvenile records, conviction or arrest record, sex (including pregnancy), gender identity or expression, military status, genetic information, atypical hereditary cellular or blood trait, disabled veterans, veterans of the Vietnam era, disability (including AIDS and HIV related illnesses) and any other characteristic protected by federal, state, or local law.

Med-Metrix and/or Medi-Centrix will not discriminate against any employee or applicant for employment because of race, creed, color, sex (including pregnancy), religion, national origin, military status, sexual orientation gender identity, expunged juvenile records, conviction or arrest record, age, disability, genetic disposition or carrier status, domestic violence victim status, or marital status, military status, atypical hereditary cellular or blood trait, disabled veterans, veterans of the Vietnam era, disability (including aids and HIV related illnesses) and any other characteristic protected by federal, state or local law.

Med-Metrix and/or Medi-Centrix will not discriminate against any employee or applicant for employment because of race, creed, color, sex (including pregnancy), religion, national origin, military status, sexual orientation gender identity, expunged juvenile records, conviction or arrest record, age, disability, genetic disposition or carrier status, domestic violence victim status, or marital status, military status, atypical hereditary cellular or blood trait, disabled veterans, veterans of the Vietnam era, disability (including aids and HIV related illnesses) and any other characteristic protected by federal, state or local law.

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