An A/R representative is responsible for timely and accurate follow-up and appeal of denials/rejections received from third-party payers. The representative will manage their assigned work to ensure payer appeal/filing deadlines are met and achieve optimal payment for services rendered.
Graduate with 1-5 years’ experience in the US health care industry (HB or PB – HB preferred).
Ability to read and interpret the insurance explanation of benefits (EOBs
Knowledge of payer edits, rejections, rules, and how to appropriately respond to each.
Accuracy in identifying the cause of rejections/denials and selecting the most appropriate method for resolution.
Demonstrated proficiency with timely and successful appeals to insurance companies
Should have excellent communication skills and the ability to remain pleasant during difficult conversations regarding outstanding bills or debts.