Lead Accounts Receivable Representative

Ellis Medicine•Schenectady, NY

About The Position

The Lead Accounts Receivable Representative manages assigned accounts receivable and completes special billing assignments and projects. The role supports and trains current and new staff, ensures accurate and timely accounting for inpatient and outpatient accounts, reviews payments and adjustments, and resolves outstanding balances with insurers and patients. The position also coordinates regular payer meetings and tracks payer communications to support timely issue resolution and improve cash flow. The representative handles patient billing inquiries and payments, estimates patient financial responsibility, performs collections, and completes daily cash reconciliation and claim-submission activities. Responsibilities include reviewing billing exceptions and claim rejection reports, correcting errors, researching unidentified cash, following up on aged accounts, and ensuring payments, allowances, and denials are handled appropriately. The role requires professional customer service, collaboration across departments, protection of patient confidentiality, and adherence to organizational standards and procedures.

Requirements

High school diploma or equivalent required.
Five years of accounts receivable experience in a hospital or healthcare setting.
Knowledge of medical records, medical terminology, billing requirements, and CPT, HCPCS, and ICD-9 coding, with the ability to apply coding to a procedure or diagnosis.
Proficiency with Windows-based software, including Microsoft Windows, Excel, and Word.

Nice To Haves

Associate’s degree preferred.
Experience with Siemens Soarian systems and Allscripts electronic health records preferred.

Responsibilities

Complete special billing assignments and projects.
Assist staff with questions and concerns and provide training to current and new staff.
Ensure accurate and timely accounting of assigned inpatient and outpatient accounts receivable.
Review payments and adjustments in the patient accounting system daily and ensure outgoing data is accurate.
Review and resolve outstanding accounts receivable with insurance companies and patients.
Review disputed claims daily and coordinate monthly payer meetings to improve communication and resolve issues.
Handle patient, payer, provider, and other customer calls and written requests in a timely, professional, and courteous manner.
Gather accurate patient billing information and estimate patient liability, including copayments, deductibles, coinsurance, and deposits.
Collect outstanding patient balances, receive and process payments, maintain petty cash, and answer questions about patient liability.
Receipt and forward patient payment receipts, post payments to patient accounts in Sorian Financials, and complete end-of-day closing and reconciliation duties, including deposit-slip reconciliation.
Provide information about programs that may assist patients and families with financial issues, such as Medicaid and Uncompensated Care.
Review billing exception reports, Medicare FISS reports, and the SSI claim scrubber daily; correct data-entry errors and report system errors to the supervisor.
Log and forward registration errors or missing claim forms for correction, verify required claim attachments, and submit claims daily to the appropriate payer.
Analyze 277 rejection reports and verify payer denials, including eligibility and edit denials.
Calculate usual and customary rates for deductibles, coinsurance, and adjustments according to reimbursement procedures, contracts, and policies.
Assist cash-posting staff with payer remittances and ensure appropriate financial-system transaction codes are applied.
Research unidentified cash with payers for correct posting or refund it to the payer within 30 days.
Review denials for appropriateness and correct them or bill the next responsible party.
Follow up on aging accounts with payers within 15 to 45 days of the insurance or guarantor bill date and document account activity.
Send appropriate correspondence to insurers and guarantors to obtain payment status or establish arrangements.
Complete required training and respond promptly to customer requests while providing excellent customer service and collaborating with other departments.
Maintain patient confidentiality and adhere to privacy policies and procedures.
Follow Making Ellis Exceptional behaviors and standards and AIDET; initiate, promote, and support change initiatives.
Complete daily tasks in accordance with the position’s policies and procedures and perform additional duties as assigned.