Billing/AR Representative (Hybrid-Duluth, GA)

Who We Are:

With a legacy spanning over 20 years, Integrated Practice Solutions is the market leader in practice management software for chiropractic (ChiroTouch, ACOM Health), optometry (RevolutionEHR), and therapy practices (ClinicSource) across the United States. We are a growing and profitable, privately funded organization who stays ahead of the pack by constantly innovating, growing, and developing new products and services that serve the health and wellness profession. Our software helps practitioners create a positive in-clinic experience for patients, from scheduling to treatment to payment and insurance processing. Our vision – to be the most loved, most essential software and service provider for every practice – is not just words. These words reflect who we are as a company, and who we are as people. 

RCM Department Overview: The Revenue Cycle Management (RCM) department helps providers get paid for their services. From clearinghouse enrollments to patient accounts, to insurance claims, our RCM team members help practices grow and succeed financially.

Your Career Opportunity:

The Medical Claims Biller/ AR Representative manages the full RCM services, including timeliness and accuracy of scheduled EDI/Paper claim submissions for multiple billing company clients and report reconciliation process against billing software. This includes claim A/R follow-up, ERA posting/payment posting, medical record request, working denials and appeals.

Your Areas of Accountability:

• Ensure all EDI/Paper claims are reviewed for accuracy prior to payor submission
• Audit and reconcile EDI claims batches to ensure payor acceptance and balancing
• Ensure software reports regarding unbilled claims are worked as scheduled and issues resolved
• Work effectively with clients/staff to resolve any payor edits and/or errors that effect timely claims submissions
• Report claims related issues to clients and/or staff for corrections
• Retain fax transmittal acceptance reports for all paper claims submitted via fax
• Ensure proper handling of timely filing submissions for paper claims with USPS tracking
• Review paper claims submissions to ensure accuracy prior to mailing
• Ensure medical record attachments are signed prior to submission
• Provide billing reconciliation reports to team lead/department manager
• Collection of claims/claim follow up.
• Working claim denials .
• Filing appeals.
• Submitting Medical Record Requests.
• Keeping client informed of AR issues.
• Demonstrate high level of professional integrity when communicating with payors, clients, and other staff
• Consistently meet/exceed insurance billing/claim follow up benchmarks
• Provide swift escalation to clients and/or management that have negative implications related to claims submissions
• Comply with HIPAA guidelines regarding PHI
• Communicate department backlogs and develops action plans accordingly

Competencies for Success:

• Minimum of 2 years billing experience with EDI/Paper Claim Submissions
• Minimum of 2 years working with Clearinghouse claims processing
• Comprehensive understanding of claims requirements by payor
• Thorough knowledge of commercial, government, workman’s compensation and Auto payor claim process
• Exceptional understanding and adherence with payor specific billing guidelines
• Exceptional organizational skills
• Ability to multi-task and deal with high volume claims processing
• Good typing skills and experienced with office productivity tools such as MS Word, Excel, and Outlook
• Prior knowledge of Therapy Billing and Therapy Software is a definite plus

At Integrated Practice Solutions, we carefully consider a wide range of compensation factors to determine our offers of employment. This includes internal and external market factors as well as your individual experience and skills. These considerations can cause compensation to vary but we reasonably expect to pay between $31,150-$64,650 for this position.

Integrated Practice Solutions is an Equal Opportunity Employer that values employees with a broad cross-cultural perspective. We strive to create an inclusive environment, empower employees, and embrace diversity. We encourage everyone to respond. All applicants will receive fair and impartial treatment without regard to race, color, religion, sex, national origin, ancestry, citizenship status, age, legally protected physical or mental disability, protected veteran status, status in the U.S. uniformed services, sexual orientation, gender identity or expression, marital status, genetic information or on any other basis which is protected under applicable federal, state, or local law