AMR

  • Insurance Follow -Up Representative

    Requisition ID
    2018-2694
    Category
    Customer Service/Support
    Employment Type
    Regular Full-Time
  • More Information about this Job

    POSITION SUMMARY: 

    The Accounts Receivable Specialist – Level 1 is responsible for the follow-up on all insurance claims, including resolving unpaid accounts in a timely and efficient manner for one or more geographical areas, while maintaining required quality and productivity standards.

     

    Duties and Responsibilities:

    • Review, modify, and re-bill rejected/denied claims by assigning appropriate insurance carrier, utilizing the billing address and/or payor prefix.
    • Process Acccounts Receivable items in queues within appropriate timeframes, (e.g. claims status checks, appeals of denied claims).
    • Recode private pay, commercial insurance and HMO claims, assign proper condition codes/ICD-9 codes/procedure codes into the Accounts Receivable Billing System and re-file 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 credit card payments to Cash Posting as required.
    • Review the Level of Service to be billed, including but not limited to, designating Advanced Life Support (ALS), Basic Life Support (BLS), Wheelchair, or Specialty Care Transport (SCT)/Critical Care Transport (CCT). 

     

    Knowledge and Skills (not required but helpful):

    • ICD-9/ICD-10 coding/condition codes and procedure codes
    • HIPAA Requirements
    • Flexible with shifting daily priorities
    • Meet deadlines working within tight time constraints
    • Handle a large volume of work and/or phone calls
    • Prioritize workflow
    • Process clean claims for one or more geographical areas and/or financial classes
    • Meet or exceed and sustain all established standards for productivity and quality

    Minimum Qualifications:Education/Licensing/Certification:  

    • High School Diploma or GED required

    Experience:

    •  Minimum one (1) year previous medical insurance follow-up or related office work experience required.  Ambulance billing experience a plus.

    Company offers

    • Medical, Dental and Vision Care
    • Life Insurance
    • Short-Term and Long-Term Disability
    • Employee Assistance Program
    • 401(k) Retirement Plan with a Company Match
    • Paid Time Off
    • Holiday Pay
    • Employee Discount Programs

    EEO Statement

    EOE including Veterans and Disabled

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