Account Rep - CHCA Billing

SHIFT:

• Based on specific assignment, the AR Representative is responsible to perform the following:
• Claims
• Identifies problems in Claims Edit work queue or Claim Logic Lists and resubmits claims.
• Works claim edit work queue on a daily basis and resubmit claims through the Epic billing system
• Works actions and edits through Claim Logic on a daily basis
• Paper claims processing daily including proper documentation
• Communicates all claims/data problems that cannot be handled to the Lead A/R Representative within one (1) day of identifying the problem.
• Identifies and researches all incomplete or inaccurate information on claims, demonstrate proper handling and escalation as needed.
• Notify the AR Lead when a claim backlog in Claim Logic exits from prior month outstanding greater than 3 days post month-end.
• AR Debit Follow-up
• Utilizes the Epic Billing System to review and monitor accounts through the Follow-Up work queues
• Work the Denied, Low pay and No Response accounts within the Follow-Up work queue while maintaining established productivity requirements.
• Contacts insurance carriers or other responsible parties to confirm payment dates, question why a claim was rejected or questions why a claim was not processed.
• Performs all follow- up necessary to obtain payment/resolution of claims.
• Reviews entire account to ensure claims were billed properly, payments were applied correctly and all necessary adjustments were made.
• Gathers all necessary documentation needed in order to have claims reprocessed/adjudicated
• Informs Lead of any problems that arise that require escalation within 2 days of identification.
• Documents all actions taken within the EPIC account notes section
• AR Credit Follow-up
• Responsible for review of credit balance receivables within the Credit work queues and must take appropriate action for resolution
• Document within Epic all justification for processing refunds to insurance based on process grid
• Process all system adjustment reversals timely
• Identify issues and communicate concerns to the Lead within 1 day of identifying the problem.
• All AR Reps
• Maintain file on all departmental policies and procedures/training documents.
• Document all inactive time periods and make available upon management request.

• High School Diploma / GED Required

• At least two (2) years Billing experience. Required

• Experience working with EPIC preferred
• Clear oral and written communication.
• Professional telephone etiquette.
• Able to interact with physicians, patients and co-workers in a professional and helpful manner.
• Use of billing computer and PC skills.
• Problem solving and decision making skills.
• Use of an adding machine.
• Able to work independently.