Insurance follow-up Specialist for our busy billing office in Ashland.
Hours of the position: 40 hours a week, schedule can be either 7-3:30 or 7:30-4pm
At Charles River Medical Associates, we provide a work culture that is empowering. We encourage our team to be great and give their best each day. Our valued employees are the foundation of our success and are the key to fulfilling our mission. CRMA supports employee learning and development and strives to promote within.
Job Summary
Reporting to the Team Leader of AR/FOLLOW-UP, the position will be responsible for all insurance follow-up from third-party payers, to be responded to in a courteous, timely manner.
Representatives will process patient accounts to third parties and resolve accounts to a zero balance. Expertise in all third-party billing and contracted payment agreements. The account representative is required to have good writing skills and ensure proper account documentation. Verbal communication required for relaying issues/concerns with problem accounts to supervisor and managers.
Job Functions
- Responsible for the resubmission of primary, secondary, and tertiary claims per respective regulations and policies.
- Communicate with third-party representatives as necessary to complete claims processing and /or resolve problem claims.
- Follow-up daily on post processing activity including but not limited to, rejected billings, adjustments, and rebilling, and denied claims for accounts that are greater than 30 days old.
- Maintain accounts receivable detail by use of on-line system documentation.
- Maintains standards per payer for percentage accounts >90 days.
- Works minimum standard number of accounts per payer per day.
- Meets or exceeds collection goals by payer each month.
- Works all assigned accounts at least once every 15 or 30 days, depending on balance.
- Participates in educational activities and attends monthly department staff meetings.
- Maintains confidentiality adheres to all HIPAA guidelines/regulations.
- Other duties as assigned from time to time.
Minimum Qualifications:
Education
- HS diploma or General Education Degree
Experience
- Three to Five years’ experience in medical office billing is preferred.
- Knowledge of ICD-10 /HCPCS/CPT Coding
- Basic Knowledge of third-party insurance plans
- Familiarity with medical terminology is helpful.
Skills:
- Must be able to communicate effectively when in contact with insurance carriers, third party payers and patients.
- Must be able to learn and understand patient accounting policies and procedures and how the Accounts Receivable computer system works.
- Must be able to use a computer, calculator, fax machine. Copier and other office tools efficiently to meet performance goals.
- Intermediate knowledge of Microsoft Word and Excel: and the ability to learn new programs and systems.
- Dependable in both production and attendance.
- Employees who work 24 hours or more a week are Benefit Eligible
- Health Insurance: 90% of premium paid by CRMA for fulltime staff, prorated for part-time.
- 11 paid holidays/yr. 17 vacation/sick days/yr in addition. Prorated for part-time.
- Dental, Vision, and Life available.
- 401k 4% contribution by CRMA
- FSA/HSA available