Clinic Front Office Representative at CARLE

The Accounts Receivable Representative 1 manages the accounts receivable in accordance with compliance, regulatory and billing guidelines and specific payer rules. Responsible for collection of outstanding receivables. Responsible for the accurate billing of insurance claims by validating coverage, resolving charge review edits, claim edits and front end clearinghouse and payer rejections. In addition, follows up on outstanding receivables, completes basic appeals, answers, documents and completes inquiries from patients, insurance companies, attorneys, public agencies, internal departments and 3rd party payers.

• Identifies and resolves billing and insurance set up errors to facilitate accurate and timely billing.
• Resolves charge review edits, claim edits and clearinghouse and payer rejections to facilitate accurate billing.
• Submits claims for assigned payers, including corrected and voided claims.
• Works patient, account, and follow-up work queues to perform collection activities on outstanding receivables; contacts patients, payers, attorneys or employers via phone, website/web portal or mail.
• Reviews and resolves incoming correspondence.
• Resolves underpayments, no payments, overpayments and undistributed payments for proper allocation.
• Identifies, prepares and requests adjustments.
• Responds to inquiries from patients, insurance companies, public agencies, internal departments and 3^rd party payers.
• Prepares, completes and follows up on designated payer reports and forms.
• Performs other duties as assigned.