Northwell Health A/R Representative III - Westchester Health - CBO in Katonah, New York

Req Number 001UG6

Job Category Billing Clerical

Job Description

Reviewsaccounts, identify trends, and recommend solutions to get account issues and/ordisputes resolved. Troubleshoots complex claim and cash admittance issues forappropriateness and resolution. Interprets Managed Care contracts to establishaccuracy and terms. Provides technicalguidance and assistance to A/R Reps.











  1. Review accounts and determine appropriate course ofaction to remedy outstanding issues.

  2. Follows account through payment orrejection and prepares a plan of action to proceed.

  3. Interprets Managed Care contract for rules of paymentaccuracy.

  4. Identifies trends to formulate new procedures forsolution.

  5. Investigates duplicate payments and takes appropriateaction to resolve.

  6. Interacts with management at Payer locations to remedyproblem issues.

  7. Compiles data grid with information received frommultiple sources.

  8. Interpret large quantities of data for use in determininggrid components.

  9. Troubleshoots complex claim and cash admittance issues forappropriateness and resolution.

  10. Provides technicalguidance and assistance to A/R Reps.

  11. Performs relatedduties, as required.

*ADA Essential Functions

Qualifications

  • High School Diploma or equivalent, required. Bachelor’s Degree, preferred.

  • Minimum of three (3) years related workexperience to ensure familiarity with the technical and administrative aspectsof patient accounting.

  • Knowledge of and experience with Managed Care contractsand Contract Management, required.

Must be proficient in MS Excel and Siemens Medical Solutions/Invision applications.