• Review denied claims based on assigned markets, payers and work queues within our practice management system • Accurately and efficiently processes requests for denied claims information using website portals and outbound phone calls for all Commercial, Medicare and Medicaid insurance payers • Researches and responds to documentation requests from insurance carriers in a timely manner • Processes appeals of insurance denials and follows-up until the appeal is resolved • Obtains, reviews and updates patient demographics and insurance information within both EHR and practice management billing system as needed • Complete timely follow-up on claims submitted to payer, but no response or ERA after 45 days to resolve any pending issues with claim and payer within timely filing limits • Documents clear and concise activities performed in the system for each account worked • Adheres to all HIPAA (Health Insurance Accountability and Portability Act) guidelines and regulations • Ability to consistently maintain productivity and quality expectations as defined by the leadership team • Alert management to irregularities, insurance trends and areas of concern with reimbursement • Completes other tasks and projects as assigned by RCM Leadership

• Denial Review and Resolution: Review and resolve denied insurance claims by contacting insurance carriers, researching denial reasons, and ensuring accurate billing and coding practices. • Documentation and Appeal: Compile necessary documentation to support insurance appeals and collaborate with other departments to address editing, coding, and payment issues. • Trend Analysis: Identify denial trends and work with billing and coding teams to implement process changes to prevent future denials. • Follow-up and Communication: Maintain communication with insurance companies and patients to ensure accurate and timely payment. • Compliance: Stay abreast of current insurance regulations and managed care contractual obligations. • Customer Service: May assist with patient phone calls and customer service inquiries. • Reporting: May be responsible for generating reports on denial trends and other relevant metrics. • Cash Reconciliation/Payment Posting: Review and post electronic and manual payments from insurance carriers and patients, Perform reconciliation of bank deposits to posted payments.

• Train, direct and oversee the accounts receivable and cash application team • Making hiring decisions, providing feedback on performance; development to ensure career growth and promote succession planning • Creating weekly schedule for the Accounts Receivable Team for business coverage • Completes performance reviews and time management needs for the team • Running credit cards for authorization for online ordering accounts; processing credit card payments • Regularly monitors unapplied cash and provides assistance when needed • Working with multiple departments to gather information for customers to answer questions and resolve issues • Daily outbound accounts receivable and collection calls and emails to customers regarding account status and providing payment details • Prepare and present account status reports to management upon request • Maximize recoveries through customer contact, skip tracing, or other means necessary • Work with customers to reschedule, rewrite, or extend payments when necessary • Utilize customer portals to submit and re-submit invoices and supporting documents for payment • Support daily credit activity to include review and release of pending orders as well as day to day credit and collections duties • Develop action plans to cure delinquency while following proper processes and procedures • Coordinate with Credit, Sales, dealers, and other personnel to effectively utilize all resources to maximize productivity • Releasing orders for customers; working with management for approval on exceptions • Create demand letters and formulate emails to contact customers regarding delinquency • Document all interaction with customers and vendors to ensure reporting accuracy • Make recommendations to Senior Management and Asset Management in regard to securing collateral when appropriate • Other duties as assigned

• The Patient Account Representative is responsible for working accounts to ensure they are resolved in a timely manner. • Follow-up on claim submission, remittance review for insurance collections, create and pursue disputed balances from both government and non-government entities. • Perform duties as assigned in a professional demeanor, which includes interacting with insurance plans, patients, physicians, attorneys and team members as needed. • Basic computer skills to navigate through the various system applications provided for additional resources in determining account actions. • Access payer websites and discern pertinent data to resolve accounts. • Utilize all available job aids provided for appropriateness in Patient Accounting processes. • Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account. • Maintain department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership. • Identify and communicate any issues including system access, payor behavior, account work-flow inconsistencies or any other insurance collection opportunities. • Provide support for team members that may be absent or backlogged.