The AR 3 Representative position is responsible for assisting patients with financial aspects of their hospital service and collecting outstanding balances. In this position, the candidate will also be expected to fulfill the role of mentor to both existing and newly hired patient account representatives on their team. The Senior Commercial PAR Representative will report directly to his/her supervisor and should have the required skills that will enable them to fulfill the role of acting supervisor in the supervisor’s absence. The ideal candidate must have 5 or more years of experience in the healthcare reimbursement industry primarily working with both Commercial insurance and Managed Care carriers. The Senior Commercial PAR Representative must also possess a strong knowledge and understanding of all line of business contracts. Position Objectives: Increase revenue for our client base by efficient account receivable follow-up and resolution. Essential Duties & Responsibilities: Assist supervisor with the coordination and follow up of all claims from billing through final resolution. Assist the team in the review and preparation of claims for manual and/or electronic billing submission. Identify billing errors that require correction before it can be resubmitted to the payer. Educate your coworkers on why the error exists and help them understand what needs to be done to avoid repeat errors. Assist the supervisor with the review of electronic billing system edits that are prohibiting the claim from moving through the system cleanly. Work assigned accounts on a daily basis, according to project productivity and quality goals. Review and follow up with the team on any payment errors, low reimbursement, appeals, denials, etc. that may need the Senior Commercial PAR’s expertise for resolution. When needed, assist with the development of training documentation for new hires and established staff. Create and maintain a supportive relationship with management and clients. Communicate effectively with other departments within the company on client or payer changes that may impact their respective area. Create an environment whereby the team feels comfortable coming to you with their work questions prior to going the supervisor. Keep current with all commercial and managed care pricing models, rules and regulations(including Medicare and Medicaid HMOs and managed care pricing models, rules and regulations Maintain a strong knowledge and understanding of all commercial payers within their specific project. (Including Medicare and Medicaid HMOs within their specific project. Maintain a professional attitude. Maintain confidentiality at all times. Internal Responsibilities: Adheres to all company policies and procedures including, but not limited to those identified within the Standards of Business Conduct and the Employee Handbook, as may be amended from time to time. Adheres to all applicable laws and regulations and the company's governance/compliance program. Responsible for reporting violations of the company's policies and procedures, Standards of Business Conduct, governance program, laws and regulations through the company's Help Line or other mechanism that may be available at the time of the violation. Assists with internal control failure remediation efforts. Becomes knowledgeable of internal control responsibilities through training and instruction. Responsible and accountable for internal control performance within their area of responsibility. Participates in the internal controls self-assessment process. Ensures concerns with internal control design or performance and process changes that impact internal control execution are communicated to management.
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Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed