RCM Accounts Receivable Representative II

Envision Healthcare•Nashville, TN

3d•Remote

About The Position

We currently have an exciting opportunity available for a full-time remote RCM Accounts Receivable Representative II with our Anesthesia Service Line. This position resolves third party outstanding accounts throughout the client base by means of researching claim status, identifying and resolving issues, and processing denials or other correspondence received from various payors. This position is Monday - Friday. No weekends required! Company Overview: Envision Healthcare is a leading national medical group focused on delivering high-quality care to patients when and where they need it most. You’ll find clinicians and clinical support professionals across the nation who are proud to call Envision home. We welcome teammates of every background and work in communities that reflect the racial, ethnic, gender, sexual orientation, and economic diversity of our country. Benefits: At Envision Healthcare, we offer benefits at the speed of your life. Our wide range of health and welfare benefits allow you to choose the right ones for you and your family. Best of all, qualifying employees are eligible to enroll from day one, so you can rest easy knowing you and your loved ones are protected. Envision Healthcare offers a variety of health and welfare benefit options to help protect your health and promote your wellbeing. The benefits offered include but not limited to: Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs. Paid Time Off: Envision Healthcare offers paid time off, 9 observed holidays and paid family leave. You accrue Paid Time Off (PTO) each pay period and depending on your position and can earn a minimum of 20 days and up to 25 days per calendar year.

Requirements

High School graduate or equivalent required.
1 - 2 years of accounts receivable collection experience in healthcare required.
Working knowledge of medical billing/insurance terminology.
Working knowledge of Medicare, Medicaid, and Blue Shield rules and regulations.
Handle a large volume of work.
Meet or exceed established standards for productivity and quality.
Flexible, high achiever with ability to learn quickly and meet department goals and deadlines.
Strong attention to detail.
Ability to compute percentages and basic math functions.
Ability to identify and solve moderate to highly complex problems independently.
Organized, detail oriented with excellent follow through abilities.
Can handle and prioritize multiple tasks.
Reliable, team-oriented, pleasant with excellent interpersonal skills.

Nice To Haves

Associate or bachelor’s degree in business administration or related field preferred.
Anesthesia accounts receivable collection experience is strongly preferred.

Responsibilities

Utilize proprietary software to process rejections, denials and other correspondence received from third party payors in accordance with our procedures and guidelines to resolve issues and re-bill “clean” claims for payment.
Acquire, interpret, and apply payor rules/regulations to ensure claims and appeals are submitted/processed in accordance with proper guidelines.
Research complex payor issues preventing payment and communicate the details to appropriate internal personnel for resolution.
Analyze patient account history in order to resolve claim issues.
Accurately document the system notes screen regarding any actions or updates made to the patient account.
Investigate outstanding accounts, identify issues/denials preventing resolution and communicate findings to appropriate management personnel.
Serve as the primary contact for all inbound calls from insurance companies to resolve problems and answer questions.
Attend meetings within and outside of the department, and present information as needed.
Assist in the mentoring of new representatives to the department.
Process special projects as assigned by the supervisor and other management staff.
Prepare mass appeals for large and complex payor/provider issues.
Contact hospitals, employers, and payors for verification, claim status, and to obtain additional information to satisfy processing of the claims for payment.
Maintain all department standards associated with productivity, quality, and phone statistics.
Communicate with other departments to identify and resolve issues causing rejections and denials, utilizing applications and databases.
Compose appeal letters to third party payors and compile all proper documentation including but not limited to claim forms, payor specific forms, and medical documentation as applicable.
Utilize all resources and websites as a tool to retrieve pertinent information to accounts related receivable tasks and assignments