Job Summary: The AR Rep is responsible for their assigned practices while adhering to set processes and maintaining set productivity and accuracy standards. Including, but not limited to, accurate and timely claim creation, follow-up and correspondence with providers, insurance payers and patients. Maintains data quality and integrity. Carries out all duties while maintaining compliance and confidentiality, promoting the mission and philosophy of the organization, and fostering a professional, positive work environment.
Career Band: O2 - Operations
· Has developed specialized skills or is multi-skilled through job-related training and considerable on-the-job experience.
· Completes work with a limited degree of supervision.
· Likely to act as an informal resource for colleagues with less experience.
· Identifies key issues and patterns from partial/conflicting data.
· Takes a broad perspective to problems and spots new, less obvious solutions.
· Displays knowledge of Payor/Regulatory guidelines
· Displays a sense of urgency when completing daily job functions.
Supervisory Responsibilities:
· This position holds no supervisory responsibilities.
Duties/Responsibilities:
· Prepares and submits clean claims to third party payers either electronically or by paper.
· Identifies and resolves claim related issues.
· Denial and insurance follow-up management
· Issues adjusted, corrected and/or rebilled claims to third party payers.
· Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
· Work to set and achieve monthly S.M.A.R.T goals.
· Ensure productivity standards are met.
· Ensure Client KPI’s are met.
· Other duties as assigned.
Required Skills/Abilities:
· Knowledge of medical billing/collection practices required.
· Strong keyboard skills
· Works well in environment with firm deadlines; results oriented.
· Performs multiple tasks effectively.
· Able to work both independently and as part of a team.
· Strong analytical skills required.
· Capable of making timely, independent decisions.
· Working knowledge of medical billing systems and clearinghouses
· Basic knowledge and understanding of CPT and ICD-10 coding systems including common modifiers.
· Excellent organizational skills
· Proficiency in Microsoft Office Suite
Personal Characteristics impacting performance.
1. Personal Character
2. Leadership Skills
3. Verbal/written Communication Skills
4. Coaching/Training Skills
5. Focus on Culture.
6. Extreme ownership
7. Management Process Skills
8. Overall Process Focus
9. Client Financial Analysis Skills
10. Metrics Skills
11. System Knowledge
12. Regulatory/Billing Knowledge
13. Customer Focus and Communication
14. Professional Demeanor and Appearance
15. Sense of Urgency
16. Other cost items knowledge
17. Solution driven.
18. Hold reports to expectations.
Education and Experience:
· High school diploma or equivalent
· At least two years related experience required.