Accounts Receivable Representative I

About the role

Hospital for Special Surgery is seeking a dedicated individual to join our team. We are a leading institution in orthopedics and rheumatology, consistently ranked among the best by U.S. News & World Report. Our commitment to excellence extends to our workplace culture, which fosters innovation, support, and inclusivity.

Responsibilities

• Assists with contracts
• Negotiates physician managed care contracts
• Coordinates enrollment of physicians in managed care plans
• Ensures compliance of managed care companies with negotiated contracts
• Follows up and resolves payment issues with insurance payors
• Acts as a liaison between physician offices and insurance payors
• Schedules, coordinates, and documents for all PHO related meetings
• Maintains tracking logs for insurance payor issues and accountability
• Oversees the PHO phone line, answering and responding to inquiries, and assisting with urgent physician office issues
• Maintains a satisfactory attendance record and reports for duty punctually
• Adjusts to changing situations and work assignments

Requirements

Previous applicable experience in healthcare, hospitality, or other highly visible customer service is required. Previous medical billing and customer service experience is highly desirable. Knowledge of third-party operating procedures, regulations, and billing requirements, as well as government reimbursement programs, is essential. Proficiency in computerized registration and billing systems and personal computers, including Microsoft Office Suite, is necessary. Ability to identify trends with regard to third-party payer denials and proactively problem-solve is required. Positive attitude and flexibility are also important.

Qualifications

• High School Diploma or equivalent (GED)
• Associate's degree or enrolled in college working toward degree

Skills

• CPT, ICD-10, HCPCS coding and Medical Terminology
• Proficient in uses of computerized registration and billing systems
• Uses Microsoft Office Suite
• Identifies trends with regard to third-party payer denials
• Epic experience preferred

Benefits

The salary of the finalist selected for this role will be determined based on various factors, including but not limited to: scope of role, level of experience, education, accomplishments, internal equity, budget, and subject to Fair Market Value evaluation.

Pay

The base pay scale for this position is $35.92 - $35.92.

Schedule

This position is full-time and works in a comfortable indoor area located on the hospital campus.