Job Description
Mindoula is seeking an Account Receivable Representative to join our healthcare organization. The Account Receivable Representative will be responsible for accurately processing medical claims, verifying insurance coverage, and working with patients to resolve denial issues. The successful candidate will have a solid understanding of medical billing and coding and strong oral and written communication and problem-solving skills.
Essential Duties and Responsibilities:
- Accurately review denied claims to identify root causes. Execute appropriate corrective actions, including clinical appeals, corrected claims, and data updates to secure maximum revenue recovery.
- Communicate directly with insurance representatives to negotiate settlements on accounts and resolve systemic payment discrepancies.
- Monitor denial trends and provide actionable feedback to front-end billing and clinical teams to prevent recurring errors in coding, eligibility, or credentialing.
- Follow up on unpaid claims and appeals by tracking unpaid claims, contacting insurance companies to inquire about payment, and appealing denied claims as needed.
- Stay current on state and federal regulations to ensure all recovery efforts meet legal and contractual standards.
- Document all resolution activities and maintain an organized worklist of accounts, prioritizing those nearing timely filing or appeal deadlines.
- Other duties as assigned.
Qualifications:
- High school diploma or equivalent (Associate’s or Bachelor’s degree in healthcare or related field preferred):
- At least 2 years of experience in account resolution.
- Experience with several billing and follow up systems.
- Knowledge of medical terminology, CPT and ICD-10 coding, and billing regulations: The Medical Billing Representative should have a solid understanding of medical terminology, CPT and ICD-10 coding, and billing regulations.
- Proficiency in Microsoft Office suite and G Suite, especially Excel.
- Ability to read and interpret various insurance companies’ EOBs.
- Detail oriented with accuracy, solid organization, and time management skills.
- Strong communication and customer service skills: The Account Receivable Representative should have strong communication and customer service skills. This will involve working with patients, healthcare providers, and insurance companies to ensure that claims are processed accurately and efficiently.
- Ability to work independently and as part of a team: The Account Receivable Representative should be able to work independently and as part of a team. This will involve collaborating with healthcare providers and other staff members to ensure that processes are streamlined and effective.
Location & Hours:
This is a 100% remote position that must be located in the United States. The hours of this position are Monday-Friday 8:00 AM to 5:00 PM Eastern time.
