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Accounts Receivable Representative
Cambridge, MassachusettsOrganization Facility: Mount Auburn Hospital Category: Accounts Payable & Receivable Job ID: JR15404 Date posted: 03/24/2023
When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.
Work Shift:Day (United States of America)
- Keep accounts receivable days down by claim reimbursement through third party payors, insurance companies and patients until account balance equal zero.
- Answers all calls left on voicemail from previous night, as well as all calls transferred from customer service station daily with a 48- hour period in an effort to resolve patient questions.
- Responds to correspondence sent to the office by researching and replying by letter, phone call, fax or e-mail to resolve issue at hand
- Works closely with office managers for any patient inquiries that reach them instead of outside vendors regarding statement balances for PB and HB. HB inquiries are sent to appropriate biller in HB (categorized by insurances)
- Work WQ rejections which include insurance registration issues, incorrect zip codes
- Name discrepancies, by viewing scanned insurance cards if scanned or contacting patients
- Work WQ claim edits making corrections to rejected claims. The nature of the denials
- Determine the task; i.e.. checking eligibility, subscriber DOB, incorrect, policy number, Other missing information, etc.
- Works charge edit WQ which identifies codes for new/establish patients, global period services, age vs. CPT code discrepancies
- Works Follow Up WQ which are denials from insurance companies, the nature of the denial determines the task i.e.., no referral/authorization, max benefit exceeded, missing inaccurate modifiers, WC benefit denied, new patient vs est. patient, incorrect vaccine, no administration w/vaccine etc.
- Ensures all research billing and follow up activities are completed within established time frame. Identifies claims that need additional information such as remittances and supporting documentation, attaches appropriate forms and scans, faxes or mails.
- Work in conjunction with coders for coding denials that were not reviewed prior to first submission and pose unnecessary denials.
- Identify trends and reports to billing manager to be discussed with offices: ie., authorizations not in correct field, codes that cannot be submitted together, modifiers that cannot be submitted to specific insurance, etc.
- Assist with credits by giving CP backup for patient and insurance refunds
- All conversations and activities that take place as part of the billing and collection process is well documented in Guar Acct Notes.
- Remains knowledgeable and current on third party billing, follow-up and collection applications, as well as regulatory guidelines at the federal, state and local levels
- Works with other departments to resolve issues, assist with billing in an effort to reach maximum reimbursement of services provided.
- Meets all monthly and year-end fiscal closing deadlines as they relate to the billing and collection process
- Interchanges and assists as backup for co-workers as needed, and completes other assigned duties as directed.
- Associate's vocational, or technical degree in a related field, High school graduate or GED completion.
- Extensive knowledge of third party payor rules, with requirements for billing and collections
- Knowledge of computer systems and ability to learn Specify databases
- Excellent communication skills and ability to communicate with various levels of staff and clients.
- Ability to work independently in a fast paced environment
- Comprehensive knowledge of CPT-4 and ICD-10