AR Follow Up Reps

TEKsystems•Chesapeake, VA

1d•$20 - $22•Onsite

About The Position

The AR Follow Up Rep position is responsible for ensuring the submission of timely and clean Inpatient/Outpatient claims to various government/non-government payers and taking appropriate action to resolve claim issues in order to accelerate cash collections. This role involves working out of EPIC work queues or an Aged Trial Balance (ATB) report to address aged accounts. The representative will prioritize high-dollar accounts and organize their work by the age of claims, from oldest to newest. Key tasks include reviewing accounts for payments and denials, working denials, requesting and loading medical records, contacting insurance companies to resolve denied claims, and updating coordination of benefits with patients. The role also requires analyzing trends in claim denials and collaborating with management to identify and fix recurring issues. The position is measured on high production levels and quality of work output, in compliance with established policies and standards.

Requirements

Minimum of 50+ accounts to work per day.
Proficiency in EPIC.
Experience with payer portals.
Experience with 'on base' which is the scanning system.
Strong Excel experience.
Experience with ATB (Aged Trial Balance) feedback in spreadsheets.
Work is usually divided by denial type (e.g., registration denial, authorization denial).
Hospital billing experience is a plus.
EPIC experience is a plus.
High School Diploma minimum requirement.

Nice To Haves

Hospital billing experience.
EPIC experience.

Responsibilities

Work out of EPIC work queues or an 'ATB report' (Aged Trial Balance report) to hit aged accounts more quickly.
Work high dollar accounts first, then work down from there, organizing their report by sorting claims from oldest to newest.
Review accounts to determine what has been paid, what is denied, and then begin working denials.
Request medical records from the medical records department and load them onto the provider portal.
Contact insurance companies to determine why claims have been denied.
Engage with patients to update coordination of benefits.
Perform all necessary actions to get claims paid.
Analyze trends to identify constant reasons for claim denials and work with the manager to fix these issues moving forward.
Submit Inpatient/Outpatient electronic and paper claims (UB-04 and 1500) to the appropriate government and non-government payers.
Resolve Billing errors and/or warnings identified in the Patient Accounting and Billing System.
Keep abreast of payer-specific and government requirements and regulations.
Ensure claim information is complete and accurate to accelerate cash collections.
Analyze information within the Patient Accounting and Billing system to make decisions on how to proceed with billing an account.
Process rejections by correcting any billing error and resubmitting claims to government and non-government payers.
Place unbillable claims on hold and communicate necessary information to various Hospital departments for accurate billing.
Process late charge claims if charges are not entered in a timely fashion by Hospital Departments.
Submit corrected claims if original claim information has changed.
Perform billing for complex scenarios such as interim, self-audit, combined, and split billing.
Review all imported claims and either bill or hold for further review to limit the number of unreleased claims.
Meet Billing productivity and quality requirements as developed by Leadership.
Record or generate revenue by gathering and processing information that impacts the patient revenue process.
Review patient financial records and/or claims prior to submission to ensure payer-specific requirements are met.
Follow up on unprocessed or unpaid claims until a claims resolution is achieved.
Generate letters to insurance or patients as needed to resolve unpaid claim issues.
Work on and maintain spreadsheets by sorting/adding pertinent data.
Analyze information within the billing systems to make decisions on how to proceed with the account.
Identify comments in the billing systems by using initials and approved abbreviations.
Keep documentation clear, concise, and to the point, including enough information for a clear understanding of work performed and actions needed.
Create appropriate documentation, correspondence, emails, etc., and ensure they are scanned to the proper account.
Read, understand, and explain benefits from all payers to coworkers, physicians, and patients.
Make phone calls, use the internet, and send mail to payers for follow-up on unprocessed claims, incorrectly processed claims, or claims in question.
Develop relationships with customers/patients/co-workers to gather and process information or resolve issues for accurate reimbursement and optimize customer satisfaction.
Post accurate adjustments as appropriate per billing policies and procedures, payer explanation of benefits, and management directive.
Maintain work procedures pertinent to the job assignment.
Resolve questions regarding correct charging or other concerns regarding services provided.
Complete cross-training as deemed necessary by management.
Report potential or identified problems with systems, payers, and processes to the manager in a timely manner.
Complete special project assignments in a timely fashion.
Follow HIPAA guidelines to maintain strict confidentiality of all patient financial and hospital information.
Perform other duties as assigned.