Home Infusion AR Representative

HOME INFUSION AR REPRESENTATIVE

Job Purpose

The Patient Account Representative - Home Infusion is responsible for collections and claim resolution.

Duties and Responsibilities

Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites

Meets and maintains daily productivity standards established in departmental policies

Meets and maintains quality standards established in departmental policies

Uses the MPower workflow system, client host systems and other tools available to them to collect payments and resolve accounts

Adheres to the policies and procedures established for the client/team

Perform special projects and other duties as needed. Assists with special projects by utilizing excel spreadsheets, and the ability to communicate results

Identify and report underpayments and denial trends

Initiate appeals when necessary

Ability to analyze, identify and resolve issues causing payer payment delays

Act cooperatively and courteously with patients, visitors, co-workers, management and clients

Maintain confidentiality at all times

Maintain a professional attitude

Other duties as assigned by the management team

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


Requirements:

High School Diploma required

Medical Billing and Coding certification preferred, but not required

3+ years’ experience in Home Infusion and/or Specialty Pharmacy insurance collections, including submitting and following up on claims of medical billing work experience required

Knowledge of CPT and ICD-9/10–CM coding, HCPC codes as well as 1500 forms required

Ability to work well individually and in a team environment

Proficiency with MS Office

Strong oral/written communication and organizational skills

Strong Math skills


Working Conditions

General office environment

While performing the duties of this job, the employee is occasionally required to move around the work area

Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear

The employee must be able to follow directions, to get along with others, and handle stress

The noise level in the work environment is usually minimal


Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.