Accounts Receivable Representative

Job Description

Job Description

Position Summary :

The A / R Representative plays a critical role in the financial health of our orthopedic hospital by ensuring accurate and timely follow-up on outstanding insurance claims and patient accounts. This position is responsible for managing the full revenue cycle process for assigned payers, with a strong focus on hospital billing, collections, and resolving claim denials. The ideal candidate has a solid understanding of orthopedic procedures, insurance regulations, and hospital billing practices.

Key Responsibilities :

Review and follow up on outstanding insurance claims and patient accounts to ensure timely reimbursement.

Submit and track hospital claims (UB-04) to government, commercial, and managed care payers.

Identify and resolve claim denials, underpayments, and billing discrepancies.

Communicate effectively with insurance carriers, patients, and internal departments to resolve issues and secure payment.

Maintain detailed documentation of collection activities in the patient accounting system.

Work aging reports daily to meet collection goals and minimize days in accounts receivable (A / R).

Coordinate with coding, billing, and clinical departments to correct claim errors and resubmit clean claims promptly.

Stay current with payer guidelines, regulatory changes, and orthopedic procedure billing rules.

Assist with month-end reporting and A / R reconciliation as needed.

Support continuous improvement initiatives in the revenue cycle process.

Qualifications :

High School Diploma or GED required; Associate or Bachelor's degree preferred.

Minimum 2-3 years of hospital A / R and billing experience , preferably in an orthopedic or surgical specialty setting.

Strong knowledge of UB-04 billing , payer follow-up, claim adjudication, and denial management.

Familiarity with Medicare, Medicaid, commercial insurance , and managed care plans.

Proficiency with EHR / EMR systems and billing software; Epic experience a plus.

Excellent communication, problem-solving, and organizational skills.

Ability to work independently and meet deadlines in a fast-paced environment.

Preferred Skills :

Experience with orthopedic surgical billing and high-volume claim follow-up.

Knowledge of payer contract terms, authorization requirements, and appeals processes.

Strong understanding of revenue cycle KPIs such as A / R days, collection rates , and denial trends.

For California Applicants :

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.

Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?

Company Description

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.\r\n\r\nOur commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?