Accounts Receivable Representative II- Physician Billing
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POST DATE 9/2/2016
END DATE 10/27/2016
JOB DESCRIPTIONJob Summary
The Accounts Receivable (AR) Representative II is responsible for processing all third party primary and secondary insurance claims for professional services. The Representative is required to perform heavy collections and account follow-up on all outstanding balances.
System and department specific ICARE values
INTEGRITY: We are honest and ethical in all we say and do.
COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs.
ACCOUNTABILITY: We hold ourselves accountable for all our actions.
RESPECT: We treat every individual as a person of worth, dignity, and value.
EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.
DUTIES AND RESPONSIBILITIES
Collaborates with management to reduce aging of accounts by providing verbal and written communication
Identifies claims processing issues and notify Supervisor and/or Manager to avoid further delay in claims processing
Supports coverage plans as directed by the Supervisor and/or Manager (vacation, leave of absence, etc.)
Expedites and maximizes payment of insurance medical claims by contacting third party payors and patients
Resolves edits related to billing within established Epic charge review and claim edit work queues to ensure claims are billed appropriately and timely
Enters professional charges into Epic and any associated actions to perform charge capture. Ensures completeness and accuracy of billing data (ICD-9, CPT, modifiers, etc.) when necessary
Review third party payor work queues to locate and resolve accounts
Resolve denials as they appear
Exceeds established follow-up productivity goals
Documents clear, concise and complete follow up notes in system for each account worked
Assures accounts are completed and worked at a high level of quality by visually proofreading and monitoring work output
Identifies, analyzes and escalates trends impacting AR collections
Completes special projects to improve team performance, as assigned
Demonstrates expertise of all payors, including Medicare, Medicaid and commercial payors, and applicable department s revenue cycle operations
Ensures protection of private health and personal information. Adheres to all HIPAA and PCI compliance regulations.
Participates in educational activities and attends team meetings
Remains current on collection procedures of various payors and specialty departments
Assists with knowledge sharing, payor and department training, and provide support to other team members as advised by the manager and/or supervisor
High School or GED. Associates degree preferred.
Three years physician billing experience required, preferably in a multi-specialty physician practice
In depth knowledge of CPT-4, ICD-9 and HCPCS coding. Knowledge of ICD-10 preferred
In depth knowledge of third party payer reimbursement policies and procedures
CERTIFICATES, LICENSES AND REGISTRATIONS REQUIRED
SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
Knowledge of Epic or professional and hospital system billing software related to registration, charge entry/billing and payment posting preferred.
Strong communication (verbal and written), organizational, problem solving and team player skills.
Ability to multi-task in a fast paced environment, prioritize projects and work independently with attention to detail
Demonstrate a high level of professionalism, customer service and interpersonal skills and operate under strict confidentiality due to the significant amount of PHI.
Strong and telephone and computer skills.
Ability to establish and maintain effective working relationships with employees and third party payors
Ability to work in a collaborative, team environment
Knowledge of medical billing and collection practices.
Knowledge of insurance requirements for physician visits and procedures.
Ability to be well organized, detail-oriented, and meet department deadlines in a fast paced environment
Ability to analyze, identify and articulate identified trends and report trends succinctly in a clear and concise manner
Ability to think critically and identify the global impact across the revenue cycle with a solution oriented approach
Professional Office Environment
Equal Employment Opportunity
Houston Methodist is an Equal Opportunity Employer.
Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law.
VEVRAA Federal Contractor priority referral Protected Veterans requested.