Accounts Receivable Billing Representative (Synergy)

Accounts Receivable Billing Specialist

General Summary : A full-time position responsible for continually processing claims that need to be resubmitted for payment until the claim gets paid. The goal of the Accounts Receivable Follow-Up Team is to maximize patient satisfaction and profitability by providing strong customer service to ensure that payments are received. At least two years of professional billing experience within the healthcare industry is required for this role.

Essential Job Responsibilities

• Work aged receivables utilizing A / R reports assigned by manager
• Review and assess adjudicated claims for timely and proper payment of outstanding balances
• Research, correct, and resubmit or reprocess unpaid claims as necessary
• Verify validity of account balance by researching, reviewing and ensuring accuracy of payment and adjustment posting
• Identify liability and guarantor hierarchy and transfer balances timely and appropriately
• Review and interpret Explanation of Benefits (EOB) for denials and underpayment of codes
• Research and resolve denials and underpayments with insurance carriers
• Verify all identified insurance carriers for eligibility and confirm carrier policy for referral and authorization requirements as needed for claims adjudication
• Submit carrier appeals and reconsideration requests in a timely manner
• Meet productivity goals / benchmarks as set and communicated by Team Lead
• Maintain confidentiality of patient information
• Work collaboratively with other Coding, Billing, Patient Success, and Payment Posting Specialists as needed

Education

High school diploma or GED. Bachelor's degree preferred.

Experience

Minimum of three years' billing experience in the healthcare industry. Prior medical billing experience. Knowledge of ICD-10, CPT, HCPCS coding and medical terminology required. Problem-solver / critical thinking skills / self-motivated. Ability to organize, prioritize and manage various work assignments in a timely fashion. Word and Excel experience preferred. Ability to remain professional and courteous with providers and insurance carriers always. Experience with Availity and / or Telcor is preferred.

Quality Standards

Team player who will lead by example and promote a positive work culture when partnering with internal / external business partners. Demonstrates initiative, personal awareness, professionalism, and integrity, and exercises confidentiality in all areas of performance. Follows all local, state, and federal laws concerning employment including but not limited to I-9, Harassment, EEOC, Civil rights, and ADA. Follows OSHA regulations and site protocols, policies, and procedures. Follows HIPAA, compliance, privacy, safety, and confidentiality standards at all times. Practices universal safety precautions. Promotes good public relations on the phone and in person. Adapts and is willing to learn new tasks, methods, and systems. Reports to work regularly as scheduled; consistently punctual with respect to working hours, meal and rest breaks, and maintains satisfactory personal attendance in accordance with guidelines. Consistently adheres to time management policies and procedures. Completes job responsibilities in a quality and timely manner.

Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities. This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.