Rep RCM Accounts Receivable III

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Follow up on pending claims and appeals.

• Manage escalation views.

• Review Vendor Clarification logs.

• Provide training for employees and vendors.

• Serve as a knowledge resource for team members.

• Handle Claim Acknowledgment Rejections, Claim Edits, and Charge Corrections.

• Contact patients regarding payments or to arrange payment plans.

• Print and re-file claims as necessary.

• Address correspondence on a daily basis.

• Maintain ongoing education, training, and career development within the industry.

• Meet or exceed established productivity standards.

• Respond to incoming calls from patients, insurance providers, and physician offices.

• Research and audit patient accounts for additional payments or adjustments.

• Process KAM reports as assigned.

• Achieve proficiency in the accounts receivable collector queue within 30–60 days of employment.

• Manage 40–50 accounts daily with a minimum accuracy rate of 90%.

• Calculate billing units and reimbursement amounts.

• Uphold strict confidentiality and adhere to company policies, procedures, code of conduct, and corporate mandates.

• Report any suspected or actual compliance, policy, harassment, or prohibited-activity violations.

• Seek policy clarification and utilize Compliance, Human Resources, or Legal resources when required.

• Support AMSURG’s core values of excellence, collaboration, ethical responsibility, and engagement.

⛳️ Requirements

• High School diploma or equivalent.

• 3 to 5 years of experience in a healthcare insurance receivables setting.

• Two to three years of collection experience is required.

• Proficient knowledge of CPT, ICD-9, and ASA codes.

• Strong skills in mathematics, research, analysis, decision-making, and problem-solving.

• Excellent data gathering and reporting abilities.

• Familiarity with medical terminology, insurance processing guidelines, and relevant laws.

• Advanced understanding of commercial, Medicare, and Medicaid payers.

• Knowledge of TWCC guidelines and laws, commercial managed care insurance, as well as Medicare and Medicaid guidelines.

• Strong interpersonal skills.

• Excellent verbal and written communication skills.

• Ability to work independently with minimal supervision.

• Advanced comprehension of claim requirements and billing activities, including evaluation/correction of billing edits, claim transmission, rejections, and other claim functions.

• Proficiency in Microsoft Office Suite and PC applications, including Word and Excel.

• Associate or bachelor's degree in business administration or a related field is preferred.

• Ability to maintain confidentiality and comply with company policies and procedures.

🏝️ Benefits

• Medical, Dental, Vision, Life, and Disability benefits.

• Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA.

• Transportation and Parking FSAs.

• Health Savings Account (HSA).

• Matching 401(K) Plan.

• Paid Time Off (minimum of 20 days and up to 25 days per calendar year, depending on position).

• 9 observed holidays.

• Paid family leave.

• Training and opportunities for professional growth.

• Recognition programs.

• Remote work schedule.