Title:  Patient Accounts Representative II - Appeals/Denials

Summary

We are seeking a Patient Accounts Representative II to join our team. The candidate should be an experienced collector, and should have an understanding of A/R follow-up. The candidate should also have knowledge of how to appeal a denied claim and check the status of a claim by accessing payer websites or placing a telephone call to the payer.

Job Duties

• Assists the A/R follow up team with payment reimbursement.
• Calls insurance companies or accesses payer websites for claim status, appeal status on denied claims, and payment reimbursement.
• Expedites and maximizes payment of insurance medical claims by contacting patients or insurance companies concerning unpaid accounts receivables via telephone or online systems.
• Follows up on outstanding accounts and makes proper notations (updating insurance information, using correct activity codes) in the Epic system. 
• Investigates & resolve denials, unpaid accounts, partially paid accounts, and requests for information, including appeals. 
• Reviews invoices to verify payments and accurate contractual adjustments. 
• Updates patient information and files medical claims with correct information, via electronic or paper submission.
• Assists with inquiries from outside parties regarding account status. 
• Provides guidance and technical work direction to less experienced Patient Account Representatives.

Minimum Qualifications

• High school diploma or GED.
• Two years of relevant experience.

Preferred Qualifications

• 3 years of A/R follow-up experience.