JOB SUMMARY

The Accounts Receivable Representative for Value-Based RCM, Inc. (VBRCM) is responsible for resolving payer insurance denials as a third-party, identifying trends and payer requirements, to prevent future denials.

MAJOR AREAS OF FOCUS

• Denial Resolution
• Process Improvement (Continuous Mitigation) 
• Payer Rules and Regulations

RESPONSIBILITIES

• Identify payment and denial trends and communicate to Supervisor and/or Team Lead
• Perform necessary follow-up to ensure timely resolution of appeals, obtain updated insurance information, identify, and correct billing errors, etc.
• Independently identify and communicate (verbal/written) denial reasons and steps towards resolution 
• Handle client, payer, and patient inquiries in a timely and detailed manner
• Maintain working knowledge of current Medicare, Medicaid, and third-party billing, claim form, and appeal requirements
• Maintain current working knowledge of CPT and ICD-10 codes, required modifiers and encounter data, Explanation of Benefits (EOB) reason and remark codes
• Preserve accurate and timely notes in billing system(s), ensuring a clear understanding of the activity transpired 
• Utilize payer web sites and /or portals
• Meet department productivity and quality standards
• Exhibit professional behavior and communication skills representative of VBRCM's commitment to superior customer service
• Use, protect, and disclose patient protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Perform other duties as assigned

KNOWLEDGE AND SKILLS

• Excellent problem solving and communication skills
• Working knowledge of CPT and ICD-10 
• Ability to work independently and as part of a team
• Working knowledge of medical terminology preferred
• Strong computer, typing and calculator skills 
• Ability and desire to work in a remote environment
• Strong organizational skills and attention to detail

EDUCATION/EXPERIENCE

• High school diploma or GED
• Previous medical billing experience required
• Proficient in Microsoft office (Excel, Word, and PowerPoint)

PHYSICAL REQUIREMENTS

• Prolonged periods sitting at a desk and working on a computer
• Must be able to lift up to 15 pounds at times

JOB TYPE: Full-time

HOURLY RATE: $19 - $24 per hour

JOB LOCATION: Work from Home 

BENEFITS:

• Flexible Paid Time Off
• Flexible schedule 
• Work from home
• 401K Plan with 4% company match 
• Company-sponsored medical, dental, and vision insurance 
• Company-paid long-term disability, short-term disability, and life insurance