A/R Follow-Up Hospital Representative

Avita Health System•Crestline, OH

2d•Onsite

About The Position

Reviews outstanding accounts for assigned payer and takes appropriate action to resolve issues preventing or delaying payment, including appealing denials. Works closely with the Billing Coordinator to assure initial claims are submitted correctly. Responds to inquiries and requests from various sources related to hospital claims and account processing.

Requirements

Fully knowledgeable of, and conducts all activities in accordance with regulatory compliance requirements, including but not limited to HIPAA rules and regulations, Medicare Secondary Payer Screening requirements, 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 in the process of obtaining.
AAHAM or HFMA certification, or active pursuit of certification.
Previous hospital billing experience and demonstrated knowledge of third-party billing procedures and claim review and analysis strongly preferred.

Responsibilities

Reviews outstanding accounts for assigned payer and takes appropriate action to resolve issues preventing or delaying payment, including appealing denials.
Works closely with the Billing Coordinator to assure initial claims are submitted correctly.
Responds to inquiries and requests from various sources related to hospital claims and account processing.