The AR Representative is responsible for the follow-up on all insurance claims. The incumbent will resolve unpaid accounts in a timely and efficient manner for one or more geographical areas, while maintaining quality and productivity standards set for the A/R Follow-up Representative.
- Review, modify as necessary, and re-bill rejected/denied claims in “queue” by assigning appropriate insurance carrier, utilizing the billing address and/or payor prefix.
- Process “queues” within appropriate timeframes, (e.g. claims status checks, appeals of denied claims).
- Recode private pay, commercial insurance and HMO claims, assigning proper condition codes/ICD-9 codes/procedure codes into the Accounts Receivable Billing System and re-file claims as necessary.
- Update appropriate modifiers, based on origin and destination of trip and change insurance claims as necessary.
- Create narrative in the Accounts Receivable Billing System to document status of trip for use in claim appeal process.
- Ensure that charges are billable to a particular commercial payor, based on the payor’s criteria, as needed.
- Resolve payment issues with carriers, (e.g. denials, partial payments, etc).
- Appeal claims as necessary.
- Process incoming correspondence, including signature letters, denials and additional information necessary to release the claim.
- Forward all credit card payments to Cash Posting when identified in Patient Care Report (PCR), correspondence and/or Computer Aided Dispatch (CAD) notes.
- Review the Level of Service to be billed, based on supporting documentation on the PCR and/or in the CAD notes, including but not limited to, designating Advanced Life Support (ALS), Basic Life Support (BLS), Wheelchair, or Specialty Care Transport (SCT)/Critical Care Transport (CCT).
- Adhere to all company policies and procedures.
- Adhere to and comply with information systems security. Know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered. Report information systems security problems.
- High School Diploma or GED required; Associates Degree or certificate of completion from a coding and billing school preferred.
- Minimum one (1) year previous medical billing experience or related office work experience required, ambulance billing experience preferred.
- Work in a spirit of teamwork and cooperation.
- Convey a sense of competence and commitment.
Integra Connect, LLC provides a comprehensive benefits plan.
- Medical/Dental/Vision Insurance beginning the 1st of the month following your date of hire
- 401k with employer match
- Paid Time Off
- Paid Holidays and Floating Holiday
Equal Opportunity Employer
|Job Category||AR Governmment|