Home Care PFS Accts Rec Rep

JOB SUMMARY

The primary focus of the accounts receivable representative is to provide consistent follow up on the open account receivables. Responsible to review payments received for services rendered and to determine contractual compliance. Responsible to provide payment disputes to third parties in a timely manner per payor, contractual and regulatory guidelines. Work with interdisciplinary team and appropriate pre-cert coordinator to assure authorization issues are resolved.

Essential Functions
1. Review of the accounts receivable reports and explanation of benefits to determine outstanding balances for follow up. Perform payment disputes timely and in accordance with payor, contractual and regulatory guidelines. Document all follow up activities into the patient's medical record.
2. Review payments for accuracy. Identify and report all issues and identified trends related to contractual compliance utilizing the payor issue process to management.
3. Complete payor projects as assigned and document all follow up activity.
4. Perform as necessary, eligibility checks, payer changes, crediting and resubmission of claims.
5. Assist in obtaining/maintaining department's cash goals.
6. Provide all home care patient financial services functions in accordance with CHOP, CHHC policy and all regulatory and accrediting agency guidelines
7. Perform other duties as assigned by management.

Skills:
Skills
Previous billing/reimbursement experience.
Strong organizational skills.
Strong verbal and communication skills.
Basic application and computer skills.
Strong data entry skills

Education:
Education Level
High School Diploma / GED Required

Work Experience

At least one (1) year experience with computers. Required
At least two (2) years experience in health care billing. Required

Level 2A Worker No Covid Vaccine Required