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Medical AR Representative in Neptune City, NJ at SNI Financial

Date Posted: 3/20/2020

Job Snapshot

Job Description

Medical Billing Representative

Representative is responsible for collections, account follow up, billing and allowance posting for the accounts assigned to them.

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/quality standards established in departmental policies
  • Meets and maintains quality standards established in departmental policies
  • Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts
  • Adheres to the policies and procedures established for the client/team
  • Knowledge of timely filing deadlines for each designated payer
  • Initiate appeals when necessary
  • Ability to identify and correct medical billing errors
  • Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process
  • Ability to analyze, identify and resolve issues causing payer payment delays
  • Ability to analyze, identify and trend claims issues to proactively reduce denials
  • Understanding of under payments and credit balance process
  • Perform special projects and other duties as needed. Assists with special projects by utilizing excel spreadsheets, and the ability to communicate results
  • Act cooperatively and courteously with patients, visitors, co-workers, management and clients
  • Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
  • Work independently from assigned work queues
  • Maintain confidentiality at all times
  • Maintain a professional attitude
  • Other duties as assigned by the management team


  • 2 years' experience in insurance collections, including submitting and following up on claims for a Medical Practice, Ambulatory Surgical Center, Hospital and/or other Medical Facility/Medical Billing Company
  • Physician/Professional Billing: 1 year
  • Knowledge of the denied claims appeals process
  • Knowledge of Worker's Comp and PIP
  • Previous experience in Hospital/Facility or Physician billing
  • Extensive knowledge of individual payor websites, including Navinet and Novitasphere
  • Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes
  • Ability to work well individually and in a team environment
  • Proficiency with MS Office. Must have basic Excel skillset
  • Experience with GE Centricity or EPIC PB preferred
  • Experience with EClinical Works (ECW) preferred
  • Strong communication skills/oral and written
  • Strong organizational skills


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  2. Billing Specialist Jobs