A/R Rep

Under the direction of the Medical Group’s CBO Supervisors and Managers, the A/R Rep is responsible for CBO related duties such as billing, follow-up, claim edits, credits, provider enrollment review, and other billing-related projects, cash posting and payer underpayment resolution, customer service, and/or administrative functions.

Essential Duties:

• Consistently manage and prioritize claim edit work queues to ensure all accounts are corrected and submitted timely and accurately.

• Review previous notes, correspondence, and document actions taken on account in the Practice Management System.

• Follows up on unpaid claims, identifies overpayments, and initiates refunds and adjustment process to ensure accurate and timely submission. 

• Perform account reconciliations and analysis to ensure accuracy and completeness of invoices.

• Maintains working knowledge of payor policies applicable to assigned work group.

• Works closely with the supervisor or manager in the department to report denial trends and follow up with the payer.

• Works Customer Service inquiries from patients and others to include written requests, emails, and/or answer phones.

• Works with all other revenue cycle departments and practices to resolve any outstanding encounters

• Maintain productivity and quality standards as set by CBO leadership.

• Maintains an acceptable average “Quality Review” score as set by CBO quality and productivity policy.

• Maintains an acceptable productivity average of 90% or greater.

• Maintains working knowledge of payor policies applicable to assigned work group.

• Maintain billing/coding knowledge of assigned specialty and identify trends to report up to leadership.

Minimum Education, Experience, Training and Licensures Required

• High school graduate or GED certificate required; Associate degree preferred

• 3+ years of Ambulatory/Provider Billing in a multi-specialty practice preferred

• 1-2 years EPIC Practice Management experience preferred

• Proficient with standard Windows applications (e.g., MS Office application suite, advanced skilled using MS Excel functions)

• High level proficiency in use of basic computer applications (e.g., Internet Explorer, word processing, email applications)

• Advanced keyboarding skills