Physician Services AR Representative III - Remote

JOB SUMMARY 

The primary purpose of the REP, PHYS SVC AR III team is to pursue reimbursement of services rendered and achieve accounts receivable resolution.  This team works through open accounts receivables (denials and delinquent accounts) by actively calling payer organizations or utilizing web-based connectivity.  Team members manage accounts by utilizing the IDX Paperless Collection System and Epic follow-up work queues.   

The core responsibilities of a REP, PHYS SVC AR III is to perform collection follow-up steps with insurance carriers and/or patients regarding open accounts receivable and/or delinquent accounts to result in maximum cash collections for our clients.  Specific tasks include resolving insurance carrier denials, appealing claims, contacting carriers on open accounts, and responding to insurance carrier correspondence and/or inquiries. This position holds additional duties with respect to research, client contact and participation in employee training with possible exposure to multiple practice management systems.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Contact insurance carriers through website, email or telephone to resolve outstanding accounts
• Analyze and resolve moderately complex insurance denials including coding review to prevent errors within appeals process
• Appeal and/or resubmit unresolved invoices to insurance carriers
• Research and respond to insurance correspondence
• Update registration information, post denial codes and adjustments in practice management systems
• Research and obtain required documents to resolve misdirected payment issues
• Analyze weekly denial reports to spot trends; assess opportunities to improve internal workflows
• Maintain internal logs (Excel format)
• Assist in employee training and mentorship
• Contact client for missing data elements or confirmation of information
• Others may be assigned.

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment.  This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

• High school diploma or equivalent
• 2-4 years’ experience in healthcare collections and/or healthcare related field
• Previous experience with IDX or Epic medical billing systems preferred
• Knowledge of CPT, ICD-9 and HCPCS codes
• Sharp intelligence of government payers and other commercial/managed care carrier rules and processes in a professional billing environment
• Attention to detail with the ability to identify/resolve problems and document the outcome
• Strong written and verbal communication skills
• Excellent analytical and problem-solving skills 
• Ability to multi-task and recognize trends to effectively work A/R
• Solid skill with Microsoft Office applications: Word, Excel 
• Initiative to learn new tasks and the ability to apply acquired knowledge to future duties
• Flexibility, adaptability, and accountability are necessary for optimum client results

POSITION COMPETENCIES:  

• Builds Team Relationships - Invites others to share opinions. Partners with employees in other departments. Actively seeks ways to help team members. 
• Communicates Effectively – Expresses ideas clearly and succinctly with small or large audiences.  Listens attentively to speaker’s message without interruption.  Tailors writing to audience using correct grammar and spelling.
• Compliance with Laws, Policies and Procedures - Adheres to company handbook and policies. Demonstrates behavior consistent with Code of Conduct. Adheres to compliance program and guidelines. 
• Develops Self - Seeks opportunities for continuous learning. Modifies behavior in response to feedback. Knows personal strengths and weaknesses and demonstrates ownership for personal development. 
• Displays Adaptability – Performs well in high pressure or stressful situations.  Works effectively when direction is unclear or rapidly changing.  Demonstrates persistence in the face of o