Accounts Receivable Representative II (Remote)

📋 Description

• • Own the full-cycle accounts receivable process for a portfolio of commercial, government, and third-party payers, ensuring every outstanding dollar is pursued with precision and professionalism.
• • Drive daily collections strategy by placing outbound calls, interpreting aging reports, and crafting persuasive appeals that overturn denials and accelerate cash flow for a nationwide anesthesia provider.
• • Serve as the primary guardian of revenue integrity: audit high-dollar claims, spot coding or billing anomalies, and collaborate with coders, charge-entry, and clinical teams to correct root causes before they become write-offs.
• • Master the electronic claims ecosystem—scrub 835 remittance files, correct EDI rejections in real time, and partner with clearinghouses to achieve first-pass acceptance rates above 98%.
• • Transform raw denial data into actionable intelligence: build trend dashboards, flag recurring payer policy changes, and brief leadership on emerging risks that could impact millions in annual revenue.
• • Champion the patient experience by fielding inbound billing inquiries with empathy, converting complex EOB language into plain-English explanations, and routing patients to financial counselors when appropriate.
• • Coordinate seamless secondary and tertiary billing—rebill crossover claims, update COB information, and ensure patient responsibility transfers are accurate and compliant.
• • Investigate and resolve credit balances quickly, issuing refunds or recoupments in accordance with payer contracts and federal guidelines to maintain NAPA’s sterling compliance record.
• • Contribute to month-end close by preparing cash-posting reconciliations, validating allowance for doubtful accounts, and presenting variance analyses to senior finance leaders.
• • Participate in cross-functional task forces that test new revenue-cycle software, pilot AI-driven denial prediction models, and refine workflows that reduce A/R days below 35.
• • Maintain bulletproof documentation in Epic and the billing module, ensuring every note, appeal letter, and phone call is time-stamped and audit-ready for internal and external reviews.
• • Uphold HIPAA, HITECH, and payer confidentiality mandates; escalate any suspected fraud, waste, or abuse to the Compliance Hotline within 24 hours.
• • Mentor junior representatives by sharing payer-specific tips, hosting lunch-and-learn sessions, and modeling best-in-class customer service etiquette.
• • Embrace continuous learning through NAPA’s tuition assistance, monthly coding clinics, and leadership development tracks that prepare you for roles in revenue-cycle analytics or management.