To apply for a position, please complete our Online Application.
- Responsible for uploading, attaching, and preparing medical records.
- Maintaining a list of tracking numbers with claims.
- Communicating with providers to verify mailing address destinations.
- Filling out necessary documentation to go along with records.
- Working with clearinghouse applications as needed to complete medical records.
- Updating and maintaining an assigned worklist.
- Adhere to all HIPAA guidelines and regulations.
- Other administrative functions.
- Education: High School or equivalent
- Experience: 1-2 years of office environment setting (preferably medical office)
- Basic knowledge of Microsoft Office applications (Word, Excel, Outlook)
- Experience with Adobe Acrobat Pro (PDF editing application)
- Able to operate scanner, fax, and copier.
- Ability to establish and maintain effective working relationships with employees.
- Demonstrate organization skills including ability to manage multiple tasks and meet deadlines.
- Strong problem solving skills.
- Strong written and verbal communication.
- Professional attitude and a desire to learn.
Skills / Requirements
As an insurance and AIR follow up representative, you will be responsible for supporting back-end commercial insurance follow up for our clients across the United States. The primary function is to obtain maximum revenue for our clients by working with payers to resolve denials. Candidates must have a thorough understanding of third party payment requirements and the confidence to work through billing issues with payers to obtain positive resolution.
- Resolve claim edits through an understanding of billing guidelines and payer requirements.
- Correct rejection errors and resubmit claims based on payer requirements.
- Work with clients and/or business partners to obtain necessary documents or information to ensure clean and complete claims are resubmitted.
- Comply with all government and third-party payers regulatory mandated requirements for billing and collections.
- Ability to maintain confidentiality of all information under HIPPA guidelines.
- Meet productivity and quality standards in time frame given upon completion of training.
- Work well individually and in a team environment accomplishing set goals.
- Perform other related duties as assigned.
- High School Diploma or equivalent
- Minimum of two years in commercial insurance follow up.
- Ability to work with commercial payers to identify and resolve denials to payment resolution.
- Understanding of how to read and Explanation of Benefits (EOB) form.
- Basic typing and computer proficiency, including Microsoft Office products (specifically Excel, Work, and Outlook)
- Ability to organize, self-direct and multi-task in a team environment.
- Strong attention to detail and proclivity for accurate documentation.
- Experience with office equipment: multi-functional printer/copier/fax, multi-line.
- Understanding of the entire revenue cycle process.
- Working knowledge of the UB-04 claim form.
- Knowledge of CPT and ICD coding.
- Medical billing or collections in a lab or ancillary services setting.
- Experience working in Athena.
- Competitive salary, commensurate with experience.
- Health insurance available after 60 days.
- Two schedules to choose from: M-F work week; hours 7a-4p or 8a-5p.
Required Skills and Experience:
Preferred Skills and Experience:
The Reimbursement Systems Analyst will develop a thorough understanding of host systems functionality and perform third party reimbursement analysis and reporting to support revenue cycle operations, audits, regulatory changes and performance improvement.
- Develops a thorough understanding of systems and business needs.
- Develops data collection protocols and procedures from client host systems to support revenue cycle operations.
- Provides support in the integration of separate systems utilized in the facilitation of revenue cycle functions.
- Develops, optimizes and maintains control mechanisms for monitoring productivity and quality of revenue cycle associates.
- Conducts complex and comprehensive analysis of data to support each functional area of revenue cycle.
- Assists in process improvement analysis and planning.
- Serves as escalation point for functional area staff to troubleshoot systems issues encountered in daily operations.
- Assists in financial impact analysis of regulatory or payer changes.
- Maintains a current knowledge of regulatory requirements and communicates changes as necessary.
- Assists in financial reporting development and maintenance.
- Performs other duties as assigned.
- Bachelor’s level degree (prefer degree to be in Accounting, Finance, or BCIS)
- Two plus years of related experience specific to hospital/physician office revenue cycle, third-party administration, or health insurance payer administration.
- Understanding of SQL for analysis (Ability to work in multiple SQL languages. i.e. MySQL, MSSQL, PostgreSQL, etc.)