Job Detail

**THIS IS NOT A REMOTE POSITION**

The Medcor Group, Inc. is seeking AR Reps of all experience levels to join our rapidly expanding team. We are hiring 4 positions in the next month as part of our most recent business expansion. Join our team of 70+ highly qualified, diverse, and fantastic billers as we serve Federally Qualified Health Centers (FQHCs) throughout the United States.

We encourage all experience levels to apply. Currently looking to staff Medical Billers and AR Reps

Job Description – Medical Biller (AR Representative)

Title

AR Representative

Updated: Dec 08, 2021

Description

Subject: Medical Biller (AR Rep) Job Description

Reports To: Billing Supervisor

Summary:

AR Representative will ensure the timely receipt of claim payments and minimizes bad debt accrual. AR Representative will also be responsible for keeping up with department and billing standards. This position is responsible for processing a variety of payers such as Medi-Cal, CHDP, Medicare, HMO’s, and private insurances. Additional duties include follow-up on unpaid claims within 30 days of claim submission.

Functions and Responsibilities:

• Conduct collection calls and/or correspondence in a fast-paced goal-oriented collections department.
• Manage claims collections (not patient collections)
• Provide customer service regarding collection issues (as applicable according to client contracts)
• Ability to differentiate the difference between in and out of network
• Resolve insurance discrepancies and short payments
• Contact and inquire with insurance companies for collection
• Identify issues or trending and provide suggestions for resolution.
• Review the account information and necessary system applications to determine the next appropriate work activity. Accurately and thoroughly documents the pertinent collection activity performed
• Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers. Edit claims to meet and satisfy billing compliance guidelines for electronic submission. Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory
• Document in detail problem/action/ and follow up with insurance companies until claim paid
• Possess working knowledge of Explanation of Benefits (EOB’s)
• Responsible for monitoring and maintaining assigned accounts
• Accountable for reducing delinquency for assigned accounts
• Verification of Refund Requests and Medical Records requests
• Initiate and resolve Appeals for many different insurance payers
• Respond timely to emails and telephone messages as appropriate. Communicate issues to management, including payer, system or escalated account issues
• Perform additional duties as requested by Supervisor or Management team

Qualifications and Key Competencies:

• Organizational Skills: Candidate must be detailed oriented and have good analytical and organization skills. Experience in effectively billing for various state-funded programs needed. Candidate must have the ability to work in a fast-paced environment.
• Primary Role: The primary role of the Medical Biller (AR Collections Specialist) is to oversee claim submission and oversee and manage insurance payments and denials. Excellent time management skills are a must.
• Certifications and Experience: Certified Medical Billing Specialist Certificate (CMBS), or similar certification, preferred. Minimum 5 years of medical billing experience required.
• Problem-Solving Skills: Candidate must possess abilities to problem solve, prioritize, and follow through completely with assigned tasks. Candidate must possess analytical skills to examine billing information for accuracy and completeness.
• Software Experience: Competency in Practice Management systems, Clearinghouse systems, and demonstrated accuracy in claim processing (less than 2% error rate) is required. Candidate must demonstrate ability to report our daily claim trends, identify and report out process interruptions, and be competent in peer-to-peer communication.
• Communication: This position may be responsible for autonomously communicating with clients and candidate must demonstrate ability to professionally and independently communicate appropriately (both verbally and in writing).

Essential Duties and Responsibilities:

1. Responsible for the following insurance carriers, including but not limited to:

2. Commercial FFS, CHDP, CDP

3. All Managed Care entities including LA Care, Cal Optima, IEHP etc.

4. Medicare, Medi-Cal

5. WPS/TRICARE

6. Champ VA

7. Trailblazers, Railroad Medicare

8. Reviewing aged insurance report

9. Works aged insurance AR

10. Working rejections/denials

11. Answering patient phone calls

12. Other assignments as directed by billing supervisor.

13. Adhere to highest standards of professionalism and compassion in providing billing assistance to all Medcor client patients

14. Regular and reliable attendance

15. Maintain Fraud and Abuse, HIPAA and PHI compliance requirements

16. Participate in daily team huddles and other meetings, as applicable

17. Other duties as assigned

Knowledge:

1. Knowledge of healthcare revenue cycle

2. Knowledge of CPT and ICD-9/10 coding

3. Knowledge of insurance companies and their rules and allowables

4. Knowledge of medical, insurance collections and insurance terminology

5. Knowledge of HIPAA and other applicable state/federal requirements

6. Knowledge of applicable state collection laws

Technology skills:

• Basic computer skills including Word and Excel
• Internet navigation
• EMR/EHR software experience

Physical demands

• Sitting for long periods of time.
• Move quickly when client or patient needs assistance
• Using keyboard
• Using telephone receiver

Working Conditions

• Involves frequent telephone calls with patients. Line must be clear of personal business so patients can get through.
• Work may be stressful at times. Interaction with others is constant and interruptive.
• Well lit, ventilated work space.

Equal Employment Opportunity

The MEDCOR Group, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

About The Medcor Group, Inc.

The MEDCOR Group, Inc., a.k.a. MEDCOR Revenue Services, provides a full range of medical billing services for FQHC and CHC entities on a national basis. We are a CHC-centric RCM company that is unmatched in managed care and we understand the unique and complex issues associated with FQHC/CHC clinics. MEDCOR is a second generation owned medical billing company that was originally founded in 1988. All of our work is performed in the United States.

Our executive team has post graduate degrees in healthcare, finance and public administration and are recognized leaders in the medical community.

Our mission is to provide you the provider with the maximum allowable consistent cash flow you are entitled for services rendered. We are business owners and understand the necessity of cash flow. We do this with state of the art cloud based and or client owned electronic medical records (EMR/EHR) or CCHIT certified medical billing platforms; in addition to highly trained, product specific billing staff with core competencies that are also certified.

MEDCOR is FQHC/CHC centric and a solution driven company, providing medical billing services (RCM) specifically targeting revenue cycle management issues.

Full comprehension of sliding scale, Medical and Dental services with managed care coding /split billing issues inclusive of Code 1, 2, 3, Code 11, 18, 19, 20, and its impact to revenue.

MEDCOR understands the unique difference of FQHC/CHC billing and is able to guide a practice through this convoluted system.

We have extensive expertise to identify billing IT integration problems, provide EMR billing platform setup solutions with corrective actions resulting in proper reimbursement.

EMR: Super User Expertise in AllScripts, NextGen, eClinicalWorks for FQHC, MicroMD, PracticeFusion and Kareo, Advanced MD for standard medical practices.

Note: MEDCOR is not a debt collection company nor in any way associated with any company purporting to provide bad debt collections.

Job Type: Full-time

Pay: $21.00 - $25.00 per hour

Job Type: Full-time

Pay: $21.00 - $25.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid sick time
• Paid time off
• Vision insurance

Physical Setting:

• Office

Schedule:

• Monday to Friday

COVID-19 considerations:
social distancing, masks provided, and sanitation.

Education:

• High school or equivalent (Preferred)

Experience:

• Epic: 1 year (Preferred)
• eClinicalWorks: 1 year (Preferred)
• NEXTGEN: 1 year (Preferred)

Work Location: One location