Senior Accounts Receivable Representative

About the role

The Sr. Accounts Receivable Representative is responsible for prompt and accurate follow-up of all unpaid claims within eClinicalWorks, with specific focus on claims for our specialty lines of business, such as OBL and Wound Care claims. The Sr. Accounts Receivable Representative will also support the AR Manager with presenting payer trends / denial details with internal and external customers, as needed.

Responsibilities

• Follow-up on all unpaid/denied claims with insurance carriers – working accounts to resolution.
• Conduct studies/special projects to resolve outstanding accounts receivable and address payer trends.
• Review assigned accounts to determine appropriate action needed with regards to claim resolution, appeals and resubmissions.
• Work all incoming correspondence including refund requests.
• Compare progress notes to LCD’s and medical coverage guidelines.
• Review medical documentation for medical necessity.
• Demonstrates and promotes a work culture committed to UVVC’s Core Values: understanding, nurturing, ingenuity, trust, excellence, and diversity, equity and inclusion.
• Demonstrates behaviors that are consistent with UVVC’s Standards of Conduct as outlined in our Employee Handbook.
• Maintains the confidentiality and security of Protected Health Information (PHI) in accordance with UVVC policies, the Health Insurance Portability and Accountability Act (HIPAA), and other applicable laws and regulations. PHI is a top priority of our organization.
• Establishes and maintains effective professional working relationships with all employees.

Qualifications

• 3+ years of Accounts Receivable experience in a medical setting
• Proficiency working with MS Office
• Working knowledge of eClinicalWorks preferred but not required
• Knowledge of insurance payer nuances
• Knowledge of medical terminology and medical billing
• Able to multi-task in a fast-paced environment
• Exceptionally detail oriented
• Strong knowledge of Excel
• Excellent written and verbal communication skills, including the ability to present ideas and concepts effectively
• Dependable; able to meet reliable attendance and punctuality standards
• Leads by example, promotes teamwork by fostering a positive, transparent, and focused working environment which achieves maximum results