SR A/R Specialist

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities.

Job Description Summary:

This position is responsible for submitting billings to the appropriate party and follow-up for adjudication and payment of individual claims. Communicate with patients, third party payors, guarantors, family members, medical staff, and other hospital departments on the status of claims in order to manage accounts receivable.

Responsibilities And Duties:

30%
Maintains accounts receivable balance and follows up on collection of accounts: -Reconciles cash receipts/cash posting-Updates appropriate records as payments are received. -Maintains accounts receivable, does follow-up with payors on regular and on-going basis. -Balance bills secondary insurance and patients/families. -Works with medical records to ensure complete/accurate charts for billing compliance. -Reports denials and billing problems to Account Receivable Supervisor. -Prepares recertification reports.
30%
Verifies insurance information to ensure accurate and timely billing of all patient revenue, negotiation of per diem payment with commercial payors and timely billing of all patient revenue: -Assists patients/families and staff in completion of all paperwork to obtain eligibility. -Verifies primary and secondary payors for each patient from admission paperwork. -Verifies coverage for all commercial insurance prior to admission, negotiating payment with assistance from Accounts Receivable Supervisor as appropriate. -Documents all pertinent information in the patient billing file and maintains file. -Works with patients/families to advise of potential financial responsibility. -Notifies payors of patient elections and discharges as appropriate.
20%
Coordination of third party and patient billing: -Prepares billing forms and required documentation and completes billing of all services to the appropriate payors.
10%
May assume job duties of the AR Supervisor and/or co-worker's in their absence. Responsible for training new staff and cross training of other staff on responsibilities.
10%
Performs other miscellaneous duties which includes, but is not limited to: Collecting data and preparing reports, maintaining all paper and computer files relative to the area, participate in staff meetings, support activities, and in-services and retreats to nurture personal and professional growth.

Minimum Qualifications:

High School or GED (Required)

Additional Job Description:

Must have a good understanding of medical coding and working knowledge of medical terminology. Must be able to work as part of team with attention to detail and balanced concern for both accuracy and efficiency.