Payment Review Representative

Alere delivers reliable and actionable information through rapid diagnostic tests, resulting in better clinical and economic healthcare outcomes globally.

The Payment Review Representative is primarily responsible for reviewing and analyzing the root cause of, and resolving all credit balances on patient accounts.

• Ensures the prompt, accurate and proper handling of account receivables credit
• Ensures daily account workload is completed prior to day's end
• Responsible for the review, reconciliation and resolution of accounts listed on the credit balance work list
• Review requests for refunds/offset to ensure that all efforts are reported and accurate
• Take necessary action to follow-up on assigned accounts including contractual adjustments, patient balance transfers, and completion of refund requests
• Process assigned accounts for refunds with correct insurance codes, allowance codes and financial classes
• Identify and report any payment or adjustment posting trends or issues
• Identify trends in payor overpayments and escalate to the Supervisor to determine the required action steps to reconcile the issue with the payor
• Maintains knowledge of payor contracts and federal regulations
• Maintains unit/team specific productivity expectation per policy
• Adheres to department quality assurance expectation per policy
• Performs other related duties as assigned

Education & Experience

• High School Diploma or GED
• Prior training or knowledge of medical terminology
• Minimum one year of medical claim processing or medical collections
• Excellent oral and written communication skills
• Detail oriented with a focus on exceptional customer service
• Excellent PC skills and organizational skills

Certificates

• Continued Self Improvement courses & seminars related to position along with “In House” programs provided by Alere Home Monitoring

Abilities

• Ability to grasp and understand business concepts and objectives
• Ability to develop effective relationships with management and associates
• Ability to use effective problem solving techniques
• Ability to make decisions while following company procedures and governmental guidelines
• Ability to be goal oriented and results focused
• Ability to use efficient time management skills
• Ability to communicate, both in writing & verbally, with others in a professional manner
• Ability to attend job related courses & seminars as required
• Ability to use office equipment that is relevant to job functions

Skills

• Type a minimum of 45wpm
• Detail Oriented
• Strong Computer/Software Skills
• Strong Verbal and Written Communication Skills
• Organization/Time Management Skills
• Human Relations Skills
• Superior Customer Service Skills
• High Degree of Professionalism
• Equipment Usage
• Telephone
• Fax / Photocopier / Scanner
• Computer/software
• Calculator

Physical Abilities

• Sitting at desk for long periods working on computer using keyboard and phone
• Ability to lift up to 10 pounds without assistance

Work Environment

• Office Setting