Job Details

Position Highlights

• Department: Accounts Receivable
• Hours: 40.00 per week
• Shift: Shift 1

Position Summary

The Hospital Billing Accounts Receivable Follow-up Representative is responsible for conducting follow-up process activities on outstanding payments through phone calls, online processing, fax and written correspondence, leveraging work queues to organize work efficiently. Work also includes reviewing insurance remittance advices and resubmitting claims with necessary information. The incumbent will continuously interact with physicians and insurance vendors to investigate outstanding claims and incomplete payments.

Essential Duties & Responsibilities

Under Direct Supervision of the Patient Accounts Manager, the Hospital Billing Accounts Receivable Representative will include the following:

• Responsible for Identifying and resolving any and all outstanding issues preventing claim resolution for assigned payers
• Responsible for working all no response, underpayment, and denial Work Queues
• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
• Meets and maintains daily productivity and quality standards established in departmental policies
• Maintain a relationship with provider representatives
• Update and monitor spreadsheets, projects, and audits with assigned payers
• Working knowledge of hospital regulations with regard to methods for payment of accounts and maintain a working knowledge of insurance regulations and hospital insurance contracts
• Identify and report underpayments and denial trends
• Help cover customer service phone calls as needed
• Perform special projects and other duties as needed by the management team.
• Maintain confidentiality at all times
• Use, protect and disclose patients protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
• Adheres to all Core Values (Compassion, Pursue Excellence, Cooperation and Collaboration, Upholds Honesty, and Supports Innovation).
• Adheres to all Absolutes (Privacy and Confidentiality, Professional Appearance, and Responsibility and Commitment).
• Other job related duties as assigned.

Minimum Qualifications

• Working knowledge of hospital regulations with regard to methods for payment of accounts and maintain a working knowledge of insurance regulations and hospital insurance contracts
• Must have a working knowledge of hospital billing systems.
• A minimum of 2 years experience in Hospital Accounts Receivables follow up
• Ability to analyze, identify and resolve issues causing payer payment delays Initiate appeals when necessary
• Ability to multitask, prioritize, and manage time efficiently
• Strong interpersonal skills
• Outstanding problem-solving and organizational abilities

Preferred Qualifications

• Epic hospital billing system knowledge desired
• IDX hospital billing system knowledge a plus

Comprehensive Benefits Offered

• Competitive and affordable benefits package
• Shift Differentials
• Continuing Education assistance
• Tuition reimbursement
• Student Loan relief through Fiducius
• Quick commute access from I-84, Route 9 and surrounding areas

About Middlesex Health

The Smarter Choice for your Career!

Come join one of Connecticut's Top Workplaces, and a Magnet designated organization! At Middlesex Health, we have a unique combination of award-winning talent, world-class technology, and patient-first care that's making health care better. Through our affiliation with the Mayo Clinic Care Network, Middlesex Health has access to the most advanced medical knowledge and research available.