Medical Accounts Receivable Representative - Sport Medicine and Orthopaedic

Sports Medicine and Orthopedic Center (SMOC) is hiring for a Medical Accounts Receivable Representative to assist with timely follow-up and collection on medical accounts receivable. The ideal candidate has excellent organizational skills, communication skills, with the desire and ability to learn quickly. Working as a part of the team to meet deadlines, but also being able to work independently is crucial to the success in this position. We are looking for candidate who will actively exhibit these values: Service Excellence, Transparency, Teamwork, Accountability, Hardwork, and Positive Attitude. 

Reports to: Department Manager 

Responsibilities: 

• Work to develop plan for maintaining proper coverage on all accounts. 
• Review aged accounts, trace and appeal unpaid and/or erroneously paid or denied claims. 
• Work all denials and underpayments received in established time frames and to final resolution.
• Work tickler accounts daily to ensure overall health of accounts receivable. 
• Review and address correspondence daily
• Identify trends and inform manager, as appropriate 
• Escalate issues to manager, as appropriate 
• Other responsibilities as assigned. 

Role Information: 

• Full-Time 
• Hourly 
• Non-Exempt 
• Eligible for Benefits 

Job Requirements 

Required Knowledge, Skills, Abilities & Education: 

• High school diploma or equivalent 
• Experience with medical billing and proficiency reading EOB’s
• Experience working with medical claims and denials 
• Working knowledge of the revenue cycle
• Proven experience working payer denials including but not limited to commercial, government, out of network, workers compensation, and auto-vehicle 
• Proficient with MS Outlook, Word, and Excel 
• Strong interpersonal and persuasive abilities to secure accurate and timely payment
• Ability to work in a fast-paced environment 
• Outstanding communications skills; both verbal and written 
• Positive role model for other staff and patients by working with them to promote teamwork and cooperation 
• Ability to apply common sense understanding and logic in day-to-day activities. 
• Ability to work independently and as part of a team 
• Strong attention to detail and speed while working within tight deadlines 
• Exceptional ability to follow oral and written instructions 
• A high degree of flexibility and professionalism 
• Excellent organizational skills 
• Outstanding communications skills; both verbal and written 

Preferred Knowledge, Skills, Abilities & Education: 

• Experience with healthcare billing and collections 
• athenahealth experience  
• A working knowledge of health plans is required.  
• Comfortable with electronic and manual payor follow-up.  
• Able to quickly identify trends and escalate, as appropriate.  
• Ability to read, analyze and interpret insurance plans, financial reports, and legal documents. 

Physical Demands: 

• Sitting and typing for an extended period of time 
• Reading from a computer screen for an extended period of time 
• Speaking and listening on a telephone 
• Working independently 
• Frequent use of a computer and other office equipment 
• Work environment of a traditional fast-paced and deadline-oriented office 

Key Competencies: 

1.   Communication 

2.   Attention to detail 

3.   Responsiveness 

4.   Customer Service 

5.   Execution