We are seeking a highly motivated and detail-oriented Accounts Receivable (A/R) Representative with strong Laboratory Billing experience to join our Revenue Cycle Management team. The ideal candidate will have extensive experience in insurance follow-up, denial resolution, and laboratory claim management. This role requires the ability to work efficiently in a high-volume environment while ensuring timely reimbursement and accurate claim resolution.
Key Responsibilities
- Perform A/R follow-up on outstanding insurance claims to ensure timely and accurate reimbursement.
- Meet or exceed daily productivity goals of 65+ accounts per day.
- Investigate and resolve unpaid, denied, or underpaid claims.
- Handle claim issues related to:
- Modifier 25 documentation support
- Evaluation & Management (E/M) level validation
- Medical necessity requirements
- Medical records submission requests
- Laboratory billing claims and payer documentation requirements
- Submit medical records, appeals, and supporting documentation to insurance carriers as required.
- Communicate with insurance companies through phone calls, payer portals, and written correspondence.
- Accurately document all account activities and follow-up actions within the billing system.
- Identify recurring payer trends, denial patterns, and reimbursement issues, escalating concerns when appropriate.
- Collaborate with coding, billing, and front-end teams to reduce future denials and improve reimbursement outcomes.
- Maintain compliance with payer guidelines, HIPAA regulations, and company policies.
Qualifications
- Minimum of 2 years of medical billing experience with a strong focus on Accounts Receivable follow-up.
- Proven ability to meet high-volume productivity standards of 65+ accounts per day.
- Hands-on experience with Laboratory Billing, including claim follow-up, denial management, and payer documentation requirements.
- Strong understanding of:
- Modifier 25 usage and documentation requirements
- E/M coding levels and validation
- Medical necessity guidelines
- Laboratory billing workflows and claim resolution processes
- Experience submitting medical records and supporting documentation for claim reconsideration and appeals.
- Proficiency in insurance follow-up procedures and payer portal navigation.
- Experience working with commercial, government, and managed care payers.
- Excellent written and verbal communication skills.
- Experience with AdvancedMD EMR.
- Experience supporting multi-specialty medical practices.
- Specialty billing experience in:
- Orthopedics
- Pain Management
- Podiatry
- Laboratory/Diagnostic Services
Perks
- Permanent Work From Home
- Leave Credits
- Monetary Allowance
- Annual Bonus
- Weekly Paychecks
- Fixed Weekends Off
- Thriving Company Culture with Complete Autonomy
- Exclusive Specialized Training Programs
- Unlock Your Potential with a Highly Competitive Salary
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Who are we
BizForce is one of the fastest-growing global outsourcing companies in the world, founded in the US in Tucson, Arizona and is now operational in PH!
Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.
