Patient Account Representative/Reimbursement Specialist (multiple) Job in Colorado Springs, Colorado US
ABOUT ASCEND CLINICAL
Based in Redwood City, California and privately held, Ascend Clinical, LLC is the ESRD laboratory testing leader in the United States. Serving independent dialysis clinics, chains and hospital-based providers, we are known for superior service and innovation. Service has been a key driver in our growth, and a differentiator. In addition to laboratory testing and reporting, we develop and market hosted software (SaaS) and mobile solutions to address the EMR and clinical business needs of independent dialysis providers and hospitals, and the physicians, administrative and care professionals that serve over 500,000 dialysis patients nationwide. Named one of Bay Area's Top Workplaces in 2010, we believe every day is a new opportunity to make a difference and invite you to fill out an application.
POSITION
Accounts Receivable Representative
Colorado Springs, CO
Reports to: Accounts Receivable Manager
DESCRIPTION
The A/R Representative is responsible for researching, analyzing and resolving patient account information needed to complete the revenue management process.
RESPONSIBILITIES
* Responsible for all areas of the revenue management life cycle
* Obtains necessary information critical to submitting clean claims
1. Contacting physicians for accurate coding and billing information
2. Performing eligibility and benefit checks
3. Reviewing billing information prior to submission of the claim
* Minimize bad debt by ensuring timely follow-up of unpaid claims, resolution of denials, and other payer-related correspondence
1. Research, appeal, and resolve claim rejections, underpayments, and denials with appropriate payer
2. Initiate collection follow-up of unpaid or denied claims with appropriate payer
3. Reviews and interprets payer remittances to determine appropriate action to be taken on denied claims.
* Identify root cause of claim exceptions; resolve and/or escalate issues
1. Analyzes outstanding account balances and determines plan of action to resolve
2. Determine and apply appropriate business action in absence of policies or in cases of ambiguity
3. Identifies and interprets policies related to exceptions
4. Escalates issues as needed
* Contacts payers for status of unpaid claims. Maintains knowledge/understanding of third party payer regulations for managed care, Medicare, and Medicaid accounts
* Assists other staff in account resolution
* Participates in special projects
* Maintains patient confidentiality according to compliance policies and HIPAA
QUALIFICATIONS
* Associates degree or higher in Healthcare or Accounting preferred or a minimum of 5 years experience health care
* Experience in laboratory revenue management preferred
* Knowledge of CPT, ICD-9 and HCPCS codes required
* Understanding of Medicare, Medicare Advantage, Medicaid, PPO, HMO, IPA and other payor documentation, compliance and coding requirements.
* Excellent customer service skills
* High degree of problem solving abilities required
* Medical terminology
* Experience with healthcare coding and auditing preferred
* Certified Professional Coder (CPC or CCS-P) preferred
* Strong organization skills
* The ability to prioritize assignments
* Ability to work under minimal supervision
EDUCATION
* Associates degree or higher in Healthcare or Accounting preferred