The Accounts Receivable Specialist will have strong attention to detail and analytical skills. The successful candidate will have a strong working knowledge of revenue cycle management and have a proven track record working in a healthcare practice environment in accounts receivable.
Responsibilities:
- Ensure that patients and insurance companies are properly billed for all services, and that payments are received and processed in a timely manner.
- Analyze excel spreadsheets and raw data.
- Denial management process
- Telephone insurance carrier/patient to seek resolution on accounts.
- Resolve inappropriate payments with insurance carriers that are not in compliance with payer contracts or governmental agency rates on individual accounts.
- Utilize specialized knowledge of contracts, regulatory or contractual billings guidelines to determine an account’s ability to pay after initial rejection from the payer.
- Coordinate duplicate billings, coordination of benefits, medical records or clinical documents as needed to expedite payment of insurance claims.
- Identify trends in payer non-compliance and inform management if not able to resolve with payer.
- Negotiate within specified guidelines with payers.
- Ensure secondary carrier is appropriately billed or self-pay portion is pursued.
- Follow up with appropriate staff to locate missing information.
- Ensure accurate and timely billing of all outstanding account balances to the appropriate third-party payers and patient guarantors.
- Maintain necessary logs
- Participate in departmental meetings as necessary.
- 1-3 years of accounts receivable experience working in a medical practice/healthcare field.
- 1 year experience with denial management
- Excellent attention to detail, customer service skills, and confidentiality
- Proficiency in Microsoft Applications
- Excellent written and verbal skills
- Ability to develop/implement team ideas and projects both independently and with others
- Ability to work in a fast-paced environment.
- Must possess the physical, mental, and cognitive skills needed to complete essential tasks, including abilities such as learning, remembering, focusing, categorizing, and integrating information for comprehension, problem-solving, and timely decision-making.
