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Accounts Receivable Specialist

 

Summary:

The purpose of this position is to ensure accurate, compliant, timely billing and appropriate reimbursement for multi-specialty medical professional services from various insurance payers and patients. This includes correct and timely collection of unpaid patient accounts with goals to be met, re-billing, payment posting, contractual write-offs, adjustments, appeals per multi-state and federal insurance regulations for patients receiving services with our clients.  

Essential Responsibilities:

  • Prepare and re-submit clean claims to various insurance companies either electronically or by paper in accordance with specific payer guidelines and/or contract requirements
  • Analyze and correct first pass rejected claims for completeness and accuracy of information for second pass clean claim submission
  • Research and preform all primary and secondary billing claim status follow up activities for assigned insurance plans
  • Review, evaluate and process all claim appeals through resubmission to insurance carriers with complete and accurate supporting documentation required
  • Research and recommend any customer account adjustments and/or write-offs to Manager based upon collectability of account with insurance carrier or patient
  • Recognize and report claims problems, errors, and discrepancies to management in order to proactively identify and effectively resolve billing trends in a timely manner         
  • Generate and submit monthly patient balance due statements to customers as dictated by the explanation of benefits received from their insurance carrier

Education:

  • High School Diploma, GED, or equivalent work experience
  • Experience & Background:
  • One to three (3) years of experience in medical insurance claims billing preferred.
  • Proficient in MS Excel and Word.
  • 10-Key by touch.

Language Skills:

  • Well-developed verbal, listening and phone communication skills
  • Good written communication skills with the ability to write routine correspondence

Mathematical Skills:

  • Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.

Reasoning Ability:

  • Ability to define problems, collect data, establish facts, and identify trends.
  • Ability to exercise good judgment and escalate issues appropriately

Behavioral Characteristics:

  • Strong organizational skills and ability to execute manual detailed tasks.
  • Strong customer service focus and commitment.  
  • Ability to establish and maintain effective working relationships within the team.
  • Ability to work well with diverse personalities.
  • Tactful, mature and flexible.
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