The Accounts Receivable Representative 2 is proficient in Accounts Receivable Representative 1 responsibilities. Responsible for handling escalated account and payer disputes. Handles complex edits, appeals and advanced account activities such as settlement and refund requests, bankruptcies, risk management and retro adjudication. Responsible for answering, documenting and completing inquiries from patients, insurance companies, public agencies, internal departments, attorneys and 3rd party payers. Acts as a billing and reimbursement expert for a defined payer product line.
- Must be able to perform essential job functions of Accounts Receivable Representative 1.
- Handles complex edits, correspondence and advanced level work queues such as but not limited to retro review, EOB balancing, 72 hour bundling rule, consecutive account review and credit adjustment review, etc.
- Handles escalated account activities such as but not limited to healthcare liens, settlement requests, bankruptcies, bad debt, risk management, estate claims, fraud cases and attorney requests, etc.
- Handles escalated appeals.
- Identifies payer and system issues to initiate project requests for process improvements and system optimization.
- Attends and participates in meetings with payer specific provider representatives to maximize reimbursement and minimize denials through problem solving, collaboration and consensus.
- Accountable for administering the Carle Financial Assistance Program, Illinois Uninsured Discount Program, Prompt Pay Discount Program, etc.
- Directs patients to the appropriate resources to help obtain benefits from outside services.