Insurance AR Representative

Insurance Accounts Receivable Representative
Hours of Work: M-F
Employment Type: Full Time
Shift: Day
Overview
Under general supervision this position supports the vision and mission for The Cardiac and Vascular Institute. Expectations include, but are not limited to, Insurance verification, evaluating financial responsibility of patients, updating accounts to a billable/collectible status, researching denials, claim rejections, and delays in reimbursement, utilizing all possible means to resolve accounts, which include contacting patients, insurance companies and other departments. Assists the department by organizing collection procedures and meeting performance goals while adhering to current laws and payer regulations and reducing uncompensated care.
Key Responsibilities

• Ensures correct processing of outstanding insurance claims by: interpreting insurance payer responses, requesting account level adjustments, submitting appeals and claims reconsiderations, evaluating financial responsibility of patients, resolving insurance denials and claim rejections, performing insurance verification.
• Meets or exceeds the department's established performance targets (productivity and quality).
• Initiate and follows-up on reconsiderations and appeals.
• Exercises good judgement in escalating identified denial trends or root cause of denials to mitigate future denials, expedites the reprocessing of claims and maximizes opportunities to enhance front end claim edits to facilitate first pass resolution.
• Identifies uncollectible accounts and performs accurate and timely write-offs (e.g. no authorization) adhering to department policy guidelines.
• Based on electronic payers' error reports, makes appropriate corrections to optimize the electronic claims submission process

Knowledge, Skills and Abilities

• Maintains a strong working knowledge of payer requirements and can research payer policies including LCD's and NCD's to help determine root cause for denial trends
• Strong attention to detail and accuracy.
• Ability to work independently and as part of a team.
• Proficiency with computer systems and software, including Microsoft Office and hospital systems.
• Knowledge of HIPAA regulations and compliance.
• Ability to multi-task, prioritize, and manage time effectively.
• Willingness to learn and adapt to new technologies and processes.
• Effective verbal and written communication skills are necessary in dealing with a variety of healthcare and finance professionals including senior management staff.

Qualifications

• High School Diploma or equivalent (GED).
• 3 years' work experience in insurance accounts receivable.

Preferred Qualifications

• Cardiology Experience.

Additional Information
All your information will be kept confidential according to EEO guidelines.