Medix
You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is a multi-specialty private surgical practice expanding in the coming year. They are seeking an Account Receivables Representative who will be part of a dynamic and collaborative team. The primary responsibilities include performing various follow-up tasks on out-of-network surgical and E&M claims, addressing complex denials, and writing and submitting appeals.
Key Responsibilities
Analyze EOB information, including co-pays, deductibles, co-insurance, contractual adjustments, and denials to determine and resolve issues. Obtain initial status of medical claims by calling insurance carriers and/or checking online web portals. Engage in follow-up via carrier communication through phone/online web portals to resolve issues and ensure timely and appropriate claims payment. Resolve denials and submit appeals: Identify and resolve denials and payment variances and act to resolve issues through claims reprocessing, claim corrections, and/or drafting and submitting reconsiderations/appeals. Ensure all efforts have been exhausted in resolving issues with payers prior to obtaining manager approval for write-offs. Review, follow up, and respond to inquiries via email, phone, or incoming correspondence in a timely manner to resolve outstanding balances, patient complaints, or billing process questions. Collaborate with leadership to identify and address AR issues and collaborate with internal and external teams to address billing issues. Review patient account balances to ensure all patient payments are applied appropriately and contact patients and other relevant parties to follow up on outstanding balances and make payment arrangements. Maintain detailed records of all revenue cycle activities in the EMR system. Verify health insurance benefits for patients as needed. Review and respond to insurance and/or patient refund requests. Perform other RCM-related tasks as needed within the department. Qualifications
A good foundation in claims follow-up, denial management, and/or appeals process. Quick learner with the ability to analyze data and resolve issues efficiently. Experience in follow-up via carrier communication through phone/online web portals. Experience
Prior experience with follow-up, appeals, and denials concerning surgical claims. Proven expertise with the No Surprise Act, Federal IDR process, and submissions of IDRs is a plus. Other Details:
Fully on site M-F 9am - 5pm located in White Plains, NY This is a contract to hire position
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
* As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
Job Summary
Our client is a multi-specialty private surgical practice expanding in the coming year. They are seeking an Account Receivables Representative who will be part of a dynamic and collaborative team. The primary responsibilities include performing various follow-up tasks on out-of-network surgical and E&M claims, addressing complex denials, and writing and submitting appeals.
Key Responsibilities
Analyze EOB information, including co-pays, deductibles, co-insurance, contractual adjustments, and denials to determine and resolve issues. Obtain initial status of medical claims by calling insurance carriers and/or checking online web portals. Engage in follow-up via carrier communication through phone/online web portals to resolve issues and ensure timely and appropriate claims payment. Resolve denials and submit appeals: Identify and resolve denials and payment variances and act to resolve issues through claims reprocessing, claim corrections, and/or drafting and submitting reconsiderations/appeals. Ensure all efforts have been exhausted in resolving issues with payers prior to obtaining manager approval for write-offs. Review, follow up, and respond to inquiries via email, phone, or incoming correspondence in a timely manner to resolve outstanding balances, patient complaints, or billing process questions. Collaborate with leadership to identify and address AR issues and collaborate with internal and external teams to address billing issues. Review patient account balances to ensure all patient payments are applied appropriately and contact patients and other relevant parties to follow up on outstanding balances and make payment arrangements. Maintain detailed records of all revenue cycle activities in the EMR system. Verify health insurance benefits for patients as needed. Review and respond to insurance and/or patient refund requests. Perform other RCM-related tasks as needed within the department. Qualifications
A good foundation in claims follow-up, denial management, and/or appeals process. Quick learner with the ability to analyze data and resolve issues efficiently. Experience in follow-up via carrier communication through phone/online web portals. Experience
Prior experience with follow-up, appeals, and denials concerning surgical claims. Proven expertise with the No Surprise Act, Federal IDR process, and submissions of IDRs is a plus. Other Details:
Fully on site M-F 9am - 5pm located in White Plains, NY This is a contract to hire position
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
* As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.