AR Representative - Medical Billing and Coding

Job Description

Job Description

Acentus is currently seeking a Professional Medical Biller/AR Representative to join our team!

*This is not a fully remote position. You must be able to commute and report to our Mount Laurel office. Semi-remote work may be available after the successful completion of a 90 day introductory period.*

As an AR Representative at Acentus, you will report directly to an AR Manager and work alongside other AR Representatives on one of our AR Teams: Commercial Payors, Horizon Payors, Managed Medicare & Medicaid Payors, Government Payors, Specialty Payors, or Eligibility. The ideal AR Representative maintains a positive attitude, is self-motivated and detail-oriented, and has excellent problem-solving skills which allow the delivery on on-time results to ensure the success of individuals and the organization.

Daily duties of an AR Representative include ensuring claim payment issues are resolved timely and efficiently, resolving EOB discrepancies, researching denials, and meeting key performance indicators (KPIs). Benchmarks and KPIs for an Acentus AR Representative include, but are not limited to: net and gross collection rates, days in AR, rejections, and percentage of AR over 90 and 120 days.

A qualified and dedicated AR Representative will:

• Follow up on submitted claims for payment
• Meet productivity standards and minimum requirement of at least 50-60 accounts per day
• Monitor unpaid claims and resubmit claims with appropriate corrections and/or documentation
• Work denied claims and resubmit replacement claim for payment
• Report denial trends to management
• Provide timely, accurate, and professional responses to internal, patient, and third party inquiries
• Research and resolve simple to complex issues and escalate issues to management
• Research no response claims and report root cause to management
• Work with billing managers to resolve and prevent coding denials
• Maintain and submit a detailed issues log to his/her manager to identify practice and/or payer trends
• Report needed system updates to manager
• Research payer policies and insurance eligibility changes and communicate changes to key personnel
• Work special payor projects as assigned

Successful candidates will possess the following qualifications and skills:

• Bachelor’s degree preferred, HS diploma/GED required
• Minimum of 4 years’ of experience in professional medical billing or similar role
• Ability to troubleshoot and problem solve in a healthcare setting
• Knowledge of CPT and ICD-10 coding
• Proficient understanding of HIPAA compliance practices
• Prior experience utilizing billing systems and electronic medical records (EPIC preferred)
• Proficient knowledge and a working understanding of Microsoft Excel and Word
• Knowledge of and experience using payer tools (e.g. Navinet, etc.)
• Excellent research abilities, attention to detail, and communication skills
• Outstanding problem-solving and organizational abilities
• Self-motivation, including multitasking and time management
• Positive attitude and team player