Acclara - Patient First Financial Excellence

Insurance Services High Dollar Specialist L1

Fort Washington, PA, USA Req #188
Wednesday, May 19, 2021
We work hard to make Acclara a great place to work. Our people are our greatest assets, and we encourage employees to grow and develop, assuming greater responsibilities and leadership roles.

The High Dollar Representative position is responsible for all follow-up on pre-determined balance threshold assigned accounts from the Acclara Solutions, LLC management team.  The core responsibilities of a high dollar representative include research, insurance billing and collection, self-pay billing and collection follow up as well as adjustment identification to ensure proper account resolution.  This position requires the ability to work independently, accomplish goals, excellent customer service and communication skills, creativity, patience and flexibility.  High Dollar Representatives rely on guidelines established by the organization to perform job functions and work under general supervision in a moderately fast paced environment.  High dollar Representatives usually report to the department lead or supervisor.

 

 

EDUCATION AND WORK EXPERIENCE:

High school diploma or equivalent.  A minimum of two years previous work experience as an insurance follow-up representative is required.  Must have full understanding of insurance follow-up processes (i.e. Billing, Collections, Managed Care, Medicare, Medicaid and Commercial Practices), and well-developed interpersonal skills.

 

 

REQUIRED JOB KNOWLEDGE & SKILLS:

  • Results / action oriented
  • Deliver client/ patient friendly service
  • Excellent problem-solving skills
  • Extensive knowledge of insurance filing
  • Cultural contribution to team
  • Positive attitude
  • Computer literate / able to use basic functions of a computer
  • Ability to type a minimum of 30 wpm
  • Knowledge of EOB, CPT & ICD-9 codes, HCFA, UB04, HCPCS, DRG and authorizations/referrals
  • Reliable attendance record
  • Flexible
  • Team player

 

 

CORE RESPONSIBILITIES AND JOB FUNCTIONS:

Core responsibilities include but are not limited to the items listed below:

·        Obtain Claim Status via the Telephone, Internet and/or Fax

·        Review and Interpret Contractual Terms for Managed Care, Commercial, Medicare, Medicaid and Workers’ Compensation

·        Obtain Supporting Documentation Regarding Insurance Follow-up Efforts

·        Identify Contractual and Administrative Adjustments 

·        Billing via Electronic and Hardcopy Submission

·        Obtain claim status

·        Excellent documentation and follow up

·        Submit all support requests accurately

·        Assist & Resolve Patient Inquiries/Requests in 24 Hour Period

  • Maintain no less than 30 day no activity in desk
  • Produces neat, thorough & accurate work

·        Maintain a consistent level of production

·        Follow organizations policies & procedures

 

 

 

 

 

Our Culture

  • We work hard to make Acclara a wonderful place to work. Our people are our greatest assets, and we encourage employees to grow and develop, assuming greater responsibilities and leadership roles.
  • Put the Patient First: The philosophy behind our approach is simple: drive revenue by putting the patient first. While our philosophy is simple, the key to our success is in the details.
  • Demanding Work, Diligence to Every Detail, and Passionate Service

 

Other duties as needed and assigned.

 

 

 

WORK ENVIRONMENT:

  • Physical demands:  While performing the duties of this job, the employee is occasionally required to walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; balance; stoop; talk or hear.  Specific vision abilities required by the job include close vision, distance vision, color vision peripheral vision, depth perception, and the ability to adjust focus.
  • Work environment:  The noise level in the work environment is usually moderate.

 

 

Acclara is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin.

Other details

  • Job Family Operations
  • Pay Type Hourly
  • Fort Washington, PA, USA