Accounts Receivable Representative Iii

Job summary
The Accounts Receivable Representative III is a senior role with deep coding and reimbursement experience.Responsibilities include advanced denial research and appeal, monitoring and resolving aged denials, and acting as a subject matter expert.The job requires strong computer skills, knowledge of healthcare payors and regulations, and the ability to meet productivity and quality standards.
Job seniority: mid-to-senior level
Responsibilities
• Monitor and execute work against assigned ETM work queues.• Research, file, and follow up on appeals with payors.• Research and resolve claim denials or rejections based on work team assignment.• Ability to monitor work queues and determine denial trends.• Communicate claim trends to management, as needed.• Ability to demonstrate system knowledge relative to work queues, research, and resolution.• Follow up with the correct clinical contact for additional information or corrections.• Meet productivity and quality standards as set by management.• Inform management of correspondence and communication problems.• Educate and communicate coding denials or payor policies to various stakeholders.
Requirements
• High school diploma or equivalent required.• Associate degree preferred.• Six years related experience and/or training.• CPC or AHIMA certification preferred.• Strong computer and keyboarding skills.• Experience with Microsoft Office software.• Experience with GE Centricity billing software preferred.• Working knowledge of CPT, HCPCS, and ICD-10 coding.• Ability to read, interpret, and understand medical terminology.• Advanced knowledge of healthcare payors, laws, and regulations.
Key Skills Needed
• Advanced knowledge of healthcare payors and government agencies• Knowledge of healthcare terminology, laws, and regulations• Advanced knowledge of denial types and resolution steps• Ability to take direction and work independently• Knowledge of health care specialty billing, reimbursement, and coding requirements• Proficient with data entry and multitasking in a Windows environment• Strong communication and problem-solving skills