Representative, Insurance Services (Home Health Care / Hospice)

AcclaraRemote, United States


Description

Hey there! We’re Acclara.   

As a remote-first workforce with team members in all 50 states, we’re a unique group of strategists, technologists, and service providers—all united in serving our partners to deliver the best care to their patients, helping build even healthier communities for us all to live and work in.   

We bring our one-of-a-kind selves to work each day, and we welcome (and want) you to do the same. Coffee connoisseurs, moms and dads, runners, animal lovers, adventurists—the list goes on—we all came to make a difference, and we stay because we’ve found a place where we don’t have to do it alone.   

Our team’s work is fueled by our CORE values of Commitment, Outcomes, Respect, and Empowerment. They’re the “how” behind what we do, guiding our actions as we aim to change the way technology and services come together.   

The Role   

The Insurance Services Representative position is responsible for all insurance follow-up on assigned accounts. Core responsibilities include research, insurance billing and adjustment identification to ensure proper account resolution. This position will focus primarily on home health care and hospice.   

What You’ll Do   

  • Works accounts from assigned area(s) to maximize reimbursement.
  • Ability to resolve payer rejections and denials through the appeals process as required by each payer's contracting agreements.
  • Performs systematic, consistent, and timely follow-up. Taking appropriate action to process accounts to resolution.
  • Responsible for working payer correspondence, edits, and aged accounts receivable, identifying, and correcting billing errors.
  • Resolves unpaid/under-paid claims and collections on behalf of clients.
  • Obtain claim status via various methods (telephone, internet, fax).
  • Review and interpret contractual terms for managed care, commercial, Medicare, Medicaid and/or worker’s compensation.
  • Document clear and concise notes in the patient accounting system regarding claim status and any actions taken on an account.
  • Contact various payers and patients to collect outstanding accounts. Tracks and enters all call for documentation, trending, and reporting.
  • Identifies contractual and administrative adjustments.
  • May perform billing functions via electronic and hardcopy submission.
  • Ascertains account information, corrects charge, and claim discrepancies.
  • Makes necessary corrections regarding insurance data or patient registration.
  • Obtains supporting documentation regarding insurance follow-up efforts.
  • Corrects clearinghouse and payer rejections daily, notifying management of trends.
  • Obtain pre-certifications and TARS as required by policy.
  • Review and respond to insurance/patient correspondence timely.
  • Identifies billing issues and trends and reports to management any concern or discrepancies in a timely manner.
  • May compose correspondence including claim forms, appeals, and notification to applicable parties.
  • Contact and educate patients and guarantors regarding necessary steps to resolve an outstanding insurance balance while providing exemplary customer service.
  • Maintains ongoing knowledge of third-party billing requirements. Understands billing timeliness and urgency in meeting all claim and filing deadlines.
  • Keeps current with knowledge of professional payer contracting agreements.
  • Audits and reviews daily tasks to ensure accuracy and completeness prior to end of work shift. Balances and closes batches in a timely manner.
  • Other duties as assigned.

What We’re Looking For   

  • High school diploma or GED
  • 1+ year high volume, multi-disciplined experience in billing, insurance collections/follow-up and denials/appeals (preferred)
  • Basic knowledge of AR workflow and terminology.
  • Basic computer skills to navigate through the various system applications, health plan websites to verify eligibility, benefits and claim status.
  • Ability to work independently and meet set production and quality goals.
  • Excellent customer service, communication (written and verbal), interpersonal and organizational skills.
  • Must be able to work in a fast-paced department and handle multiple tasks, work with interruptions, and deal effectively with confidential information.

Preferred Qualifications:   

  • Previous experience with numerous payer systems.
  • Previous experience in medical billing.
  • Basic knowledge of AR workflow and terminology.
  • Knowledge of computerized registration, billing, collection, and problem resolution procedures.
  • Electronic health record experience (Epic, Cerner, Meditech etc.)
  • Familiarity with medical terminology, coding, CPT/ICD-10/HCFA, UB04, HCPCS, DRG and authorizations/referrals

How We Take Care of Our Team Members   

  • Remote-first workplace, with opportunities to work on-site in certain locations
  • Comprehensive medical, dental, and vision coverage
  • Parental leave
  • 401K with company match
  • Company-paid life insurance, short-term disability, and long-term disability
  • Paid time off and holidays

Pay Range:  $16.33 - $20.00  

This compensation range is a reasonable estimate that extends from the lowest to the highest pay Acclara in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. Acclara may ultimately pay more or less than the posted range as permitted by law.   

Diversity, Equity, and Inclusion Matter   

At Acclara, you’re invited to bring more of yourself to work—not less. Your background, your culture, and your personal experiences are all important pieces of the authentic you, and we honor that. Connection is created when we show up.   

Acclara, an R1 company, is dedicated to the fundamentals of equal employment opportunity. Acclara’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, Acclara is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.   

If you need reasonable accommodation due to a disability for any part of the interview process, please contact [email protected].   

Visa Sponsorship is not available at this time. 

CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights: California Consent