Representative - A/R Follow-Up

Avita Health System is proud to serve the communities of Crawford and Richland counties through three hospitals and numerous clinic locations. Over the past few years, we’ve tripled in size, now employing over 2,300 team members and more than 200 physicians and advanced practitioners. Our mission is to deliver high-quality, compassionate care to the people who depend on us.

About the role

Reviews outstanding accounts for assigned payer and takes appropriate action to resolve issues preventing or delaying payment, including appealing denials. Works closely with the Billing Coordinator to assure initial claims are submitted correctly. Responds to inquiries and requests from various sources related to hospital claims and account processing.

Responsibilities

• Review outstanding accounts for assigned payer and resolve issues preventing or delaying payment, including appealing denials.
• Work closely with the Billing Coordinator to ensure initial claims are submitted correctly.
• Respond to inquiries and requests related to hospital claims and account processing.
• Conduct all activities in accordance with regulatory compliance requirements, including HIPAA, Medicare Secondary Payer Screening, medical necessity screening, ABN rules, Red Flag Rules, and billing and coding compliance.
• Apply knowledge and understanding of AHS managed care payer rules.

Requirements

• Fully knowledgeable of regulatory compliance requirements (HIPAA, Medicare Secondary Payer Screening, medical necessity screening, ABN rules, Red Flag Rules, billing and coding compliance).

Qualifications

• Required: Knowledge and understanding of AHS managed care payer rules.
• Preferred: Associate degree or in the process of obtaining. AAHAM or HFMA certification, or active pursuit of certification. Previous hospital billing experience and demonstrated knowledge of third-party billing procedures and claim review and analysis.

Benefits

• Competitive wages and comprehensive benefits
• Generous paid time off (PTO) to support work-life balance
• Health, dental, and vision insurance options
• 403(b) retirement plans with up to 4% employer match
• Paid parental leave
• Pharmacy discounts for employees
• Free on-site parking
• Opportunities for professional growth and internal advancement
• Recognition programs, including the DAISY Nursing Award for excellence

At Avita, we’re committed to creating a supportive, inclusive, and empowering environment where every team member plays a vital role in delivering exceptional care to our communities. Whether you're on the front lines or behind the scenes, your work matters here.

Location: Avita Health System – Crestline – Patient Financial Services Department