Accounts Receivable Specialist

Description

Accounts Receivable addresses the denied claims and follows up with insurance companies regarding unpaid claims. Once insurance has paid, patient responsibility is addressed with the patient. The goal of AR is to collect money payable for services provided and lowering the aging AR report.

Essential Functions

• Regular and reliable attendance is an essential function of this position. 
• Prepare and analyze AR reports, including aging reports, collection forecasts, and revenue flow projections.
• Review reports to identify revenue opportunities and unpaid claims.
• Contact insurance carriers regarding open, pending and rejected or partially adjudicated claims and invoices, as well as preparing accounts for appeals processes.
• Follow up on open receivables, working across payers from the highest dollar value to the lowest.
• Identify coding and denial issues and communicate back to supervisor.
• Research root issue of denial and pursue proper course of appeal, as well as to follow up and obtain payment.
• Address incoming correspondence and prepare correspondence to insurance companies, patient and/or guarantor.
• Contact insurance companies/patient/guarantor to obtain status of outstanding claims and submitted appeals.
• Document the claim issue and course of action taken on every account worked.
• Escalate issues and problems to Supervisor as appropriate.
• Perform charge corrections.
• May assist with special projects as directed by Supervisor/Manager.
• Perform other related duties as assigned.

Competencies 

• Strong attention to detail
• High degree of confidentiality
• Excellent written and verbal communication skills
• Professional and courteous customer service 
• Excellent time management and organizational skills
• High level of critical thinking and problem-solving capabilities

Meeting Expectations

Team/Staff meetings as scheduled. 

Supervisory Responsibilities

None

Work Environment

This position operates in a typical office environment.

Physical Demands

Prolonged periods of sitting at a desk and working on a computer.

Education and Experience

• High school diploma or equivalent 
• Previous experience in clerical/office support work and/or medical billing preferred.
• Candidate must demonstrate the ability to understand and navigate the payer adjudication process.
• Patient financial and practice management system experience and other electronic billing systems is preferred.
• Knowledge of medical terminology in an academic healthcare setting is preferred.

Additional Requirements 

• Employees in this role are considered essential workers as part of the critical infrastructure. 
• No prior criminal history.
• Ability to utilize technology.
• Proficient computer skills- Microsoft Office, Microsoft Outlook, Windows, specifically Excel
• Ability to operate basic office equipment.

Disclaimer:

Please note this job description is not designed to cover or contain an exhaustive list of all expectations, duties or responsibilities that are required of the employee for this job; employees may be required to perform additional functions. The company reserves the right to revise the job description at any time. The employee must be able to perform the essential functions of the position satisfactorily. If requested, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of their job, absent an undue hardship.