Payment Recovery Specialist

Description

Position Overview

Performs A/R insurance follow up on rejected and denied insurance claims to ensure timely and accurate payment.

Essential Functions

• Communicates effectively with all levels - patients, co-workers, supervisors and physicians, both verbally and in writing using the AIDET framework.
• Provides excellent customer service to internal and external customers through prompt response and courteous communication within 24 hours of the request.
• Work denied or rejected claims daily through correspondence, practice management tasking system and claims clearinghouse.
• Maintain not started and follow up tasks with payers according to timely filing, follow up dates, and worklog manager to ensure prompt collections and avoid timely denials.
• Place refunds on the refund spreadsheet for disbursement as needed per POSC and payer policy.
• Ability to write effective appeal letters and claim reconsideration requests using payer policy, coding guidelines and other reputable sources to overturn denials and ensure proper claim payment.
• Ability to interact with patients, co-workers, physicians and management team to explain EOBs, accounts, and insurance rules/regulations such as deductibles, co-pays & coinsurance.
• Research payer guidelines as needed to ensure proper claim payment and provide feedback to teams in the business office. Monitors electronic postings by payers to update teams on policy changes.

Other

• Attend meetings and huddles as assigned.

· Assist team members as needed.

· Other duties as assigned.

Pay Information: $19-$26/hour

Requirements

Knowledge/Skills Abilities Required· High School Diploma preferred.· Strong customer service skills.· AR insurance claims follow up experience.· Experience writing complex appeals.· Working knowledge of practice management, EMR, and claims clearinghouses.· Excellent interpersonal communication skills.· Ability to maintain quality control standards.· Ability to meet deadlines.· Ability to multi-task. · This person must be able to establish and maintain effective working relationships with patients, employees and the public.Physical and/or Mental RequirementsThe physical and/or mental requirements outlined in this job description detail the requirements as the positions essential functions are typically performed.If you need an accommodation to perform the essential functions of the position, please contact Human Resources.· Must work well under pressure · Must be able to read, understand and follow oral and written instruction. · Ability to communicate via telephone and written word to give and receive information to and from patients and coworkers.· Ability to move about an office setting. · Prolonged periods of sitting at a desk and working on a computer.DisclaimerThe information contained herein is not intended to be an all-inclusive list of the duties and responsibilities of the job, nor are they intended to be an all-inclusive list of the skills and abilities required to do the job.It does not prescribe or restrict the tasks that may be assigned to this position, and management reserves the right to alter the position’s duties, reporting and function at any time at the sole discretion of management.