Sr Accounts Rec Rep

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  • Assist Supervisor in organizing work assignments for the team.
  • Assist Management on Payer/claim research, providing all documentation as needed.
  • Perform team quality audits weekly/monthly.
  • Update team members on new processes for billing claims efficiently.
  • Provide training for existing and new employees on all billing systems, tools and resources provided to the team.
  • Prepare, edit and ensure all claims are submitted accurately and timely per payer contract and guidelines.
  • Utilizing Payer Provider Portals to obtain various aspects of claim processing
  • Provide timely responses to all written correspondence inquiries regarding claim/account status.
  • Manage claim assignments, via work queues and/or work lists and ensure proper follow up is performed on the accounts for cash resolution.
  • Keep supervisor advised of any compliance, system(s), and/or payer trend issues which may lead to untimely or inaccurate completion of claim submission/resolution.
  • Contact insurance carriers on a daily basis for claim status and patient information either by phone or website; determine reason for the lack of payment or underpayment.
  • Complete all assignments according to schedule.
  • Achieve and consistently maintain daily, weekly and monthly productivity and quality goals as determined by departmental needs and standards.
  • Must have the ability to Identify/resolve claim and or payer issues as they occur.
  • Perform other tasks as assigned to support the goals of the organization.
  • Blue Cross Blue Shield experience

Experience


Required

  • 1 year(s): HCFA CMS 1500 Claims
  • 2 year(s): Revenue Cycle Management
  • 1 year(s): Blue Cross Blue Shield CMS1500 HCFA Claims and Billing Processes
  • 2 year(s): Medical Billing

Education


Required

  • High School or better

Skills


Required

  • Identify/Resolve Problems
  • English written/verbal
  • Microsoft Office
  • Time Management
  • Medical Terminology
  • Communication Skills
  • Managerial Experience
  • Leadership
  • Claims Processing
  • Analysis

Behaviors


Required

  • Thought Provoking: Capable of making others think deeply on a subject
  • Team Player: Works well as a member of a group
  • Leader: Inspires teammates to follow them
  • Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
  • Dedicated: Devoted to a task or purpose with loyalty or integrity

Motivations


Required

  • Self-Starter: Inspired to perform without outside help
  • Goal Completion: Inspired to perform well by the completion of tasks
  • Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization

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.

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