Accounts Receivable/Collections Specialist

1. Analyze and review processing of insurance claims.
2. Post Electronic Remittance Advices (ERAs), as assigned, and check any rejected payments and verify that all payments posted.
3. Drafting and submitting medical appeals
4. Follow adjudication policies and procedures to ensure proper payment of claims.
5. Follow up on pending claims and unpaid claims in a timely manner, preventing timely filing denials.
6. Researching and appealing denied claims
7. Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
8. Review EOBs for accuracy of payments
9. Maintains required billing records, reports, files, etc. according to protocol.
10. Additional support for daily deposit preparation.
11. Other duties as assigned.

Education: High school diploma or equivalent. Some college preferred.
Experience: Minimum two years of recent accounts receivable experience or any equivalent combination of experience, training and/or education approved by the Medical Billing Supervisor and/or Human Resources

Performance Requirements:
Knowledge:
1. Knowledge of billing practices and medical office policies and procedures.
2. Knowledge of medical coding (CPT and ICD-10), clinic operating policies and third-party operating procedures and practices.
3. Knowledge of legal and regulatory government provisions.
4. Knowledge of HIPAA Privacy and Security rules.
Skills:
1. Skill in establishing and maintaining effective internal and external working relationships.
2. Skill in verbal and written communication with patients and insurances.
3. Skill in accuracy and detail with respect to demographics data and figures.
Abilities:
1. Ability to work in team based work setting which places patient satisfaction as the major focal point for measuring success.
2. Ability to demonstrate compassion and caring in dealing with others.
3. Ability to project a pleasant and professional image.
4. Ability to effectively articulate information and respond to questions.
5. Ability to relate to and work well with a diverse community population.
6. Ability to work under pressure.
7. Ability to Multi-task and meet deadlines.
8. Ability to work cooperatively with other department staff.
9. Ability to plan, prioritize, and complete delegated tasks in an appropriate time frame.
10. Ability to read, interpret and apply policies and procedures.
11. Ability to set priorities among multiple requests.
12. Ability to interact with patients, medical and administrative staff, and the public effectively.
13. Ability to work with computers.
Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.
Work Environment: Position is in a well-lighted, well-ventilated, adequate space.
Mental/Physical Requirements: Involves sitting approximately 80 percent of the day, walking or standing the remainder with light lifting (10-30 lbs.) occasionally required.