North American Credit Services, Inc. · 1 day ago
Representative, CBO Client Billing
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Responsibilities
Research unpaid, underpaid, denied or unresolved insurance balance client accounts submitted to various health care payers.
Read, and understand with proficiency, and interpret Explanations of Benefits (EOBs) from various insurance carriers.
Familiar with medical terminology, including CPT and ICD-10 codes.
Solid experience in processing claims and managing insurance appeals and disputes.
Communicates with clients via phone or email regarding outstanding balances to obtain payment details in client systems.
Review research billing grids, protocols, and coverage analysis to determine correct study is being performed and billed.
Review and correct pre-bill claim edits related to research protocols.
Works closely with Cash Management department to provide necessary back-up for payments made via credit card.
Review A/R with contracts to verify charges are entered per contract to ensure contract compliance.
Research payment discrepancies and provide evidence to posting.
Answer internal and external calls and answer questions pertaining to accounts.
Makes manual corrections to invoices via PDF creator for invoices.
Communicate with Supervisor any issues regarding billing discrepancies.
Monitor research account details for non-payments, delayed payments, and other irregularities.
Complete full audits of research clients.
Investigate and resolve customer queries.
Process adjustments.
Provide supervisor with details regarding any trends or severely aged A/R.
Qualification
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Required
High school diploma or equivalent is required
Prior relevant work experience in AR/Medicaid/Commercial health insurance processes
Demonstrated customer service experience and/or experience in a customer service-oriented environment
Strong customer service orientation with demonstrated commitment to meet/exceed customer needs
Ability to maintain reliable and predictable attendance
Strong verbal/written communication and interpersonal skills
Demonstrated ability to work in a fast-paced, structured environment, handling large call volumes
Computer proficiency is essential
Self-directed with the ability to perform both as part of a team and individually
Ability to adapt and work effectively in a continuously changing environment
Consistently demonstrate a high level of professionalism through a strong work ethic that positively influences the work habits of the team
Detail-oriented with a focus on quality and consistently meeting goals
Ability to read and comprehend complex instructions, correspondence, and memos
Ability to write and present information to leadership, vendors, clients, and other employees of the organization
Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals
Ability to compare rate, ratio, and percent and to draw and interpret various graphs
Ability to deal with problems involving several concrete variables in standardized situations
Ability to plan, organize, delegate, and prioritize work
Ability to provide clear and effective direction to staff
Ability to communicate effectively orally and in writing
Ability to establish and maintain effective working relationships with MedSrv departments, vendors, other businesses, and our clients
Must be able to multi-task
You may be required to lift between 30-50lbs at times
Preferred
Medical Coding degree/certificate or an Associate degree
Benefits
Paid time off
Full benefits package
Matching 401k plan
Balanced work-life schedule – NO WEEKENDS!
Casual work environment
Career Development
Company
North American Credit Services, Inc.
North American Credit Services, Inc. specializes in the professional collection of healthcare receivables.