A/R Follow-Up Hospital Representative

Avita Health System•Crestline, OH

5d•Onsite

About The Position

Avita Health System is seeking a dedicated A/R Follow-Up Hospital Representative for its Patient Financial Services Department at the Crestline location. The representative reviews outstanding accounts for assigned payers and takes appropriate action to resolve issues preventing or delaying payment, including appealing denials. The role works closely with the Billing Coordinator to help ensure initial claims are submitted correctly and responds to inquiries and requests from various sources related to hospital claims and account processing.

Requirements

Be fully knowledgeable of and conduct all activities in accordance with regulatory compliance requirements, including HIPAA, Medicare Secondary Payer Screening, medical necessity screening and ABN rules, Red Flag Rules, and billing and coding compliance rules and regulations.
Knowledge and understanding of AHS managed care payer rules.

Nice To Haves

Associate degree or currently pursuing one.
AAHAM or HFMA certification, or actively pursuing certification.
Previous hospital billing experience and demonstrated knowledge of third-party billing procedures and claim review and analysis.

Responsibilities

Review outstanding accounts for assigned payers and take appropriate action to resolve issues preventing or delaying payment.
Appeal claim denials.
Work with the Billing Coordinator to ensure initial claims are submitted correctly.
Respond to inquiries and requests related to hospital claims and account processing.
Conduct activities in accordance with applicable regulatory compliance requirements, including HIPAA, Medicare Secondary Payer Screening, medical necessity screening and ABN rules, Red Flag Rules, and billing and coding compliance rules.