REP RCM Accounts Receivable III

New

JobgetherHealthcare revenue cycle

Based in the United StatesFull-TimeMiddle

Salary not disclosed

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Job Details

Experience: Three to five years of experience in a healthcare insurance receivables environment. Two to three years of collection experience required.
Required Skills: Microsoft Excel

Have a high school diploma or equivalent.
Have three to five years of experience in a healthcare insurance receivables environment.
Have two to three years of collection experience.
Bring working knowledge of CPT, ICD-9, and ASA coding systems.
Understand medical terminology, insurance processing requirements, and applicable healthcare regulations.
Have an advanced understanding of commercial insurance, Medicare, Medicaid payer requirements, and reimbursement guidelines.
Be familiar with TWCC guidelines and laws, commercial managed care insurance, and relevant claims procedures.
Be able to evaluate and correct billing edits and manage claim transmissions and rejections accurately.
Have strong mathematical, research, analytical, decision-making, and problem-solving skills.
Be proficient with Microsoft Office, particularly Word and Excel, and general PC applications.
Be able to work independently with limited supervision, manage competing priorities, and meet remote productivity and quality standards.
An associate or bachelor’s degree in Business Administration or a related field is preferred.
Experience in healthcare billing, payment posting, medical coding, or accounts receivable collections, particularly within a healthcare organization, is preferred.

Follow up on outstanding healthcare claims and appeals to support timely reimbursement.
Review escalation queues, vendor clarification logs, correspondence, and account reports to identify and resolve outstanding issues.
Investigate claim acknowledgment rejections, billing edits, charge corrections, and claim-processing discrepancies.
Research and audit patient accounts to determine appropriate payments, adjustments, and corrective actions.
Contact patients about outstanding balances and arrange payment plans when necessary.
Respond to calls from patients, insurance companies, and physician offices.
Print and resubmit claims, manage daily correspondence, and address claim transmission issues.
Work key account management reports and accounts receivable collection queues, processing approximately 40–50 accounts daily while meeting accuracy and productivity standards.
Calculate billing units and reimbursement amounts.
Train employees and vendors and serve as a resource for team members.

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