Accounts Receivable Specialist

Division:Eskenazi Health  

Sub-Division: Hospital  

Req ID:  23338 

 

Schedule: Full Time 

Shift: Days 

 

Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus including at a network of Eskenazi Health Center sites located throughout Indianapolis.

 

 

 

FLSA Status

Non-Exempt

Job Role Summary

The Accounts Receivable Specialist may be responsible for maintaining the life of a claim which may include the following: Initiate Billing, Charge Entry, Claim Edit, DNB, Stop Bills, Claim Rejection, Denial, Follow-up, No Response, Variance, Correspondence and Credit Balance Resolution. The Accounts Receivable Specialist communicates with the insurance carriers to ensure appropriate and compliant payment of services via: telephone, email, fax, payor website. This position reviews reports to determine trends and discusses with management to help resolve front-end errors, reviews and follows up on all claims not paid by carriers in a timely manner and claims not paid appropriately.

Essential Functions and Responsibilities

• Proactively contributes to Eskenazi Health’s mission:   Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County.   Models Eskenazi Health values of Professionalism, Respect, Innovation, Development and Excellence.
• Assist customer service with follows up on patient calls within a timely manner
• Maintains department weekly production and monthly quality measures
• Communicates effectively and appropriately with internal and external customers
• Acts independently seeking guidance when necessary to remain compliant with federal, state, and hospital policies relative to insurance patient billing
• Initiates proper course of action for problem solving resolution
• Analyzes all claim denials to determine the best course of action to resolve any issue and receive appropriate payment
• Verifies and updates claims with insurance and demographic information when changes are needed
• Resolves inquiries from internal and external customers
• Takes active role in special projects as requested
• Gathers and distributes insurance information obtained through verbal and/or written communication for the purpose of maintaining sufficient cash flow
• Analyzes and resolves issues reported from the self-pay outsource vendor
• Utilizes interpersonal communication strategies/skills to achieve desired outcome/results with patients/families and others
• Provides coverage for co-workers as necessary due to PTO/illness
• Continues knowledge based learning on payor guidelines and requirements for appropriate billing
• Enter daily charges for NTP clinic
• Works charge review in a timely and accurate manner to ensure appropriate billing of services
• Resolves claim edits, rejections (internal/external), DNB, Stop Bills, follow up, variance, denials, credit balance resolution and correspondence
• Initiate Billing/Charge Review resolution

Job Requirements

• Associate Degree in business-related field or technical training in coding and/or billing in lieu of
• Three years of experience in medical practice/hospital setting with billing, insurance follow-up and/or credit balance experience.
• CPC Certification a plus
• Dental, Vision, Behavioral Health and/or DME experience a plus

Knowledge, Skills & Abilities

Pays close attention to detail with accuracy in record keeping and documentation
Identifies trends with denials (providers/locations/carriers) and works with management to help educate or resolve errors from the start and avoid back-end denials
Willingness and ability to assist other team members
Excellent problem-solving skills and ability to cooperate with others
Works independently and efficiently
Working knowledge of Microsoft Office Software, Windows
Utilizes calculator, printers, copiers, and fax machines
Strong