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A.R. Representative/ Claim Status medical biller in Los Angeles, CA at TeamHealth

Date Posted: 5/22/2019

Job Snapshot

Job Description

JOB DESCRIPTION OVERVIEW:

Under direct supervision, the Accounts Receivable Representative is responsible for making phone calls to insurance companies to find out the status of claims and reviewing denied claims. This position enters the status update information into the company billing system, enters denial codes to allocate claims to the appropriate location, and re-bills claims if necessary.  The position works in a cooperative team environment to provide value to customers (internal and external).  The Receivables Management Representative carries out his/her duties by adhering to the highest standards of ethical and moral conduct, acts in the best interest of TeamHealth and fully supports TeamHealth’s focus on supporting its physicians while following the billing center policies and procedures.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Responsible for contacting insurance companies and navigating payer websites to obtain accurate status information of outstanding claims and inputs accurate information into the computer billing system.
  • Responsible for reviewing the denied claims and allocating them correctly by denial code to the appropriate location.
  • Responsible for re-billing patient claims if necessary.
  • Responsible for all daily productivity reporting requirements.
  • Maintains and exceeds department standards for productivity and quality.
  • Maintains knowledge of internal denial codes.
  • Continually seeks to understand and act upon employer/customer needs, concerns, and priorities. 
  • Meets employer/customer expectations and requirements, and gains employer/customer trust and respect.
  • Functions effectively within a team and participates and contributes constructively to produce results in a cooperative effort.
  • Demonstrates ongoing enthusiasm and commitment to the work assigned.
  • Works with others to receive feedback on performance and create a personal developmental plan.
  • Participates in a process to continually improve organizational effectiveness using self-assessment performance evaluation criteria.
  • May perform special assignments and other related tasks as assigned.

 

Job Requirements

QUALIFICATIONS / EXPERIENCE:

  • Normally, the knowledge, skills and abilities necessary for adequate job performance can be obtained through approximately one+ years’ experience with insurance denials and correspondence processes within a multi-facility environment.
  • In addition, working knowledge of insurance processes, denials, and insurance eligibility requirements.
  • Also, demonstrated success working in a team environment focused on meeting organization goals and objectives is necessary.
  • Experience with providing visible participation and support of major change initiatives preferred. Some college coursework in business administration or accounting preferred.
  • Knowledge of basic math and the ability to perform math functions in units of American currency.
  • Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form.
  • Ability to review documents for accuracy and reasonability.
  • Ability to work well under pressure.
  • Tact and patience when dealing with individuals at all levels, both within and outside the company.
  • Commitment to IPC values
  • Ability to communicate effectively orally, in person and on the telephone, and in writing, with individuals at all levels, both within and outside the company.
  • Knowledge of coordination of benefits requirements and processes.
  • Knowledge of health insurance correspondence denial processing.
  • Knowledge of insurance rejection/denial processing to perform follow up activity.
  • Ability to multi-task, set priorities and follow through without direct supervision.
  • Ability to type efficiently and accurately.
  • Ability to operate a computer (i.e., Microsoft Office and internet) efficiently and accurately.
  • Ability to operate various office machines (i.e., fax, copier).
  • Ability to work well in a team environment and be flexible in problem solving environment.
  • Have good attendance.
  • Work at a desk, utilizing a computer.
  • Communicate by telephone.
  • Operate a PC and other office equipment (copier, fax, etc.).
  • Move freely between offices.

PHYSICAL / ENVIRONMENTAL DEMANDS:

  • The work environment corresponds to the average office environment
  • Have good attendance.
  • Work at a desk, utilizing a computer.
  • Communicate by telephone.
  • Operate a PC and other office equipment (copier, fax, etc.).
  • Move freely between offices

DISCLAIMER:

Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.

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