Accounts Receivable Specialist is responsible for processing and posting the payments from the insurances and patients, overseeing the collections and statement matters, and issuing refunds to the insurances and patients for overpayments. Primarily responsible for effective collection of patient accounts, accounts receivable follow-up, and reimbursement analysis.
Experience: 2 years working with AR and experience working with Medical Coding/Billing (Required)
Education: High school or equivalent (Required), Associate Degree (Preferred)
Certifications: Billing/Coding certification preferred
Duties and Responsibilities:
- Analyze insurance reimbursement receipts.
- Proficiency with the receivables management system including but not limited to patient registration, charge entry, coding, claims processing, collections, reports, and patient information inquiry.
- Perform follow-up actions with insurance companies to ensure timely payment in full.
- Post deductibles, write-offs, and payments as per EOBs/ERAs
- Correctly allocate payments for line item posting.
- Utilize account information to assist in write-offs for inclusive CPTs by the payor.
- Provides customer service both on the telephone and in the office for all patients and authorized representatives regarding patient accounts following office protocol.
- Follow-up on all returned claims, correspondence, account reconciliations and rebills receipt to achieve maximum reimbursement promptly with an emphasis on patient satisfaction.
- Performs patient collections through monthly statements, phone, and email.
- Actively searches for solutions to problems and presents ideas and recommendations to Management.
- Retroactive verification of eligibility. Always attempts to verify inaccurate/missing information.
- Ensures compliance with all State, Federal, and Central Business Office issues, including but not limited to patient-rights, Fair Debt Collections Practices, and other collection practices.
- Update job knowledge by participating in educational opportunities.
- Serve and protect sensitive information by adhering to professional standards, company policies and procedures, federal, state, and local requirements, and standards.
- Interface with Billing Manager in communicating and resolving difficult AR issues
- Other duties as assigned
Skills:
- Ability to work independently and efficiently
- Ability to research and understand billing guidelines and policies
- Working knowledge of the Medical terminology, Medical Accounts Receivable, and billing processes (rejections, denials, appeals).
- Working knowledge of various reimbursement methodologies, including reimbursement reductions, fee schedule calculations and comparisons and review of claims for correct payment Detail oriented.
- Strong interpersonal and communication skills as well as the ability to maintain professionalism under pressure
- Positive attitude, great organizational skills, and the ability to prioritize and multitask. An effective communicator, including over the phone.
- Strong interpersonal and communication skills as well as the ability to maintain professionalism under pressure
- A team player, interact productively with other team members
- Bilingual (Spanish/Portuguese) preferred
- EClinical Works EMR experience preferred
Job Type: Full-time
