Primary Responsibilities:

• Perform timely follow-ups on all accounts to ensure prompt payment.
• Maintain daily work queue in accordance with ASD guidelines.
• Identify and correct coding or billing issues from Explanation of Benefits (EOBs).
• Monitor unpaid insurance claims through reporting and direct insurer communication.
• Rebill accounts and file secondary insurance claims with necessary documents.
• Follow up on insurance denials with coders and physicians to secure reimbursement.
• Handle patient and insurance inquiries efficiently.
• Update patient account records with relevant actions taken.
• Utilize AdvantX for updates, daypack processing, and claim re-filing.
• Assign bad debt accounts to collection agencies with approval.
• Act as a liaison for third-party account collections.
• Reconcile accounts referred to outside agencies.
• Administer contracts with third-party payers, including Medicare and Medicaid.
• Notify leadership of contract discrepancies.
• Negotiate payment plans for self-pay accounts following company policies.
• Generate weekly collections reports for the CBO Director and Administrator.
• Maintain accounts receivable days within the ASD goal.
• Reduce and manage bad debt per ASD guidelines.
• Conduct weekly/monthly reviews of aged accounts for collection placement.
• Follow Best Practices for claim follow-ups at 21-28 days, then every 10-14 days.
• Answer inbound calls as needed.
• Attend required meetings and participate in committees.
• Provide backup support for business office and admissions.
• Cross-train and perform additional duties as required.
• Key Performance Indicators (KPIs):
• Manage a minimum of 60 patient accounts per day.
• Send an average of 35 accounts to outside collections monthly.
• Maintain CAD date current within 28 days.
• Handle an average of 40-70 external calls daily.
• Complete 50-70 follow-ups with insurance or patients daily.
• Process and mail 10-50 patient statements each morning.

Preferred Qualifications:

• Previous experience with Advantx (EMR/Billing System).
• Familiarity with NV and CA IPA insurance, including authorization and referral requirements.

Schedule:

• Monday - Friday
• Earliest start time: 6:30 AM
• Must work 40 hours weekly (No part-time availability)
• Some flexibility in shift times

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.