Accounts Receivable Representative
Crestview Health & Rehabilitation Center - Atlanta, GA

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SUMMARY

The Accounts Receivables Representative will be responsible for performing resolution-oriented follow up activity for third party payers and assist in billing activities. Resolution-oriented collection activity of third-party insurance balances, coordinate re-billing, appeals and adjustment of accounts based on payer responses and hospital audits. Ensure claims are adjudicated at the payer in accordance with contracted guidelines regarding timely processing and allowable reimbursements. Effective and efficient management of assigned receivables. Develops and maintains relationships with the third party payer representatives. Comply with workflow changes to support the changing environment and achievement of high high quality, productivity, and performance of the department. Escalate issues identified to management along with recommended solutions

JOB REQUIREMENTS

· High School diploma or GED required

· Two - three (2 - 3) years experience with the following:

a. Hands-on knowledge of Medicare and Medicaid billing regulations and experience with UB-04 and HCFA 1500 claim forms billing and follow up functions both electronic and manual

b. Hands-on knowledge of CPT, ICD-9 coding, HCPCS, revenue codes and terminology for hospital billing

c. Hands-on knowledge of CCI, OCE edits

d. Working knowledge of Medicare Secondary payer as well as medical necessity requirements

e. Demonstrated service and success in teamwork and consistent high productivity and quality

· Business knowledge and results oriented experience within Patient Financial Services

· Experience within a large academic teaching facility is desirable

· Siemens INVISION, EPIC, ePREMIS experience preferred

· Demonstrated knowledge and experience with the Microsoft Suite skill set to include Excel and Word

· Highly motivated and detail oriented with excellent teaming skills

· Excellent communication, time management, and organizational skills

· Demonstrated ability to be flexible, work collaboratively among internal and external departments, as applicable to identify and help resolve enterprise-wide challenges

· Demonstrated ability to effectively investigate, analyze and problem solve

· Demonstrated ability to accurately type 30 wpm

· Successfully complete competency exam with 80% proficiency

LONG TERM CARE EXPERIENCE PREFERRED

Grady Health System - 22 months ago - save job
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