A Medical Accounts Receivable Representative is responsible to ensure resolution on all claims assigned. Claims must be thoroughly reviewed to determine next steps towards collecting all allowable payments. This includes, but is not limited to, ensuring that there is no missing or incomplete information, understanding and applying payer guidelines and regulations, contacting the appropriate payers as needed, and meticulously tracking billing and appeals to ensure no claim falls outside of filing deadlines
RESPONSIBILITIES:
- Analyze patient accounts.
- Decide whether follow-up us required or not.
- Follow up through Web/ Phone/ fax etc.
- Decide on the action to be taken in the account.
- Complete the action and suggest further action.
- Document findings
- Follow-up on all outstanding insurance claims, 60-days and greater from the date of service and in accordance with work allocation.
- Follow-up on all returned claims, correspondence, denials and rebills within the specified timeline to achieve maximum reimbursement in a timely manner.
- Follow-up on insurance claim denials, exceptions, or exclusion to ensure timely processing.
- Reading and interpreting based on insurance explanation of benefits.
- Make necessary arrangements for medical records requests, completion of additional information requests, etc. as requested by insurance companies.
- Provide excellent customer service, determines needs to make a phone call to resolve the claim and handles the account appropriately.
- Other tasks/functions that may be assigned by the company as per business requirement; these may change from time to time to reflect the changing requirement of your position and our business.
Qualifications:
- Candidate must have reached at least second year college.
- At least 2 yrs of relevant experience
- Experience working in high volume support desk environment
- Strong writing and grammatical skills
- Above average written and verbal communication skills
- Experience in handling Customer Service accounts for English speaking customers a plus
