Medical Insurance Accounts Receivables Representative I (Hospital) at nThrive

Posted in Customer Service 25 days ago.

This job brought to you by Local Organization

Location: Plano, Texas

Job Description:


Equal Opportunity Employer EOE M/F/D/V

Medical Insurance Accounts Receivables Representative I (Hospital)


Job ID: 2019-27031
Type: full-time
# of Openings: 1
Category: Accounts Payable, Receivable


The Medical Insurance Accounts Receivable Representative is responsible for ensuring the timely collection of outstanding government or commercial healthcare insurance receivables.


  • Contacts government or commercial healthcare insurance companies to follow up on outstanding accounts receivable.

  • Identifies billing errors for correction and resubmits claims to insurance carriers.

  • Follows up on payment errors, low reimbursement and denials.

  • Reviews insurance EOB’s and initiates appeals as necessary.

  • Prints and mails UB04s or HCFA 1500s as necessary for account resolution.

  • Remains up to date with all commercial and managed care pricing models, rules and regulations.

  • Remains up to date with all Medicare and Medicaid rules and regulations.

  • Supports nThrive’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to nThrive’s business practices. This includes: becoming familiar with nThrive’s Code of Ethics, attending training as required, notifying management or nThrive’s Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.


  • High school diploma or GED.

  • At least one year of experience in healthcare insurance accounts receivable follow up, working with or for ahospital/hospital system, working directlywith government or commercial insurance payers.

  • Experience identifying billing errors and resubmitting claims as well as following up on payment errors, low reimbursement, and denials.

  • Experience reviewing EOB and UB-04 forms to conduct A/R activities.

  • Knowledge of accounts receivable practices, medical business office procedures, coordination of benefit rules and denial overturns and third-party payer billing and reimbursement procedures and practices.

  • At least one year of experience with accounts receivable software.

  • Experience navigating payer sites for appeals/reconsiderations, benefits verification, and online claims follow up.

  • Demonstrated ability to navigate Internet Explorer and Microsoft Office, including the ability to input and sort data in Microsoft Excel and use company email and calendar tools.

  • Demonstrated success working both individually and in a team environment.

  • Demonstrated experience communicating effectively with payers, understanding complex information and accurately documenting the encounter.

  • Ability to work effectively with cross-functional teams to achieve goals.

  • Demonstrated ability to meet performance objectives.