Healthcare Accounts Receivable Specialist

Description:

The primary responsibility of medical accounts receivable managers is to oversee a healthcare facility’s billing department. They must ensure that patients and insurance companies are properly billed for all services, and that payments are received and processed in a timely manner.

Essential Responsibilities

• Telephone insurance carrier/patient to seek resolution on account
• Resolve inappropriate payments with insurance carriers that are not in compliance with payer contracts or governmental agency rates on individual accounts
• Utilize specialized knowledge of contracts, regulatory or contractual billings guidelines to determine an account’s ability to pay after initial rejection from payer
• Coordinate duplicate billings, coordination of benefits, medical records or clinical documents as needed to expedite payment of insurance claims
• Identify trends in payer non-compliance and inform management if not able to resolve with payer
• Negotiate within specified guidelines with payers
• Ensure secondary carrier is appropriately billed or self-pay portion is pursued
• Determine an individual’s ability to pay and seeks additional assistance either through governmental programs or uncompensated care programs
• Follows up with appropriate staff to locate missing information
• Ensure accurate and timely billing of all outstanding account balances to the appropriate third-party payers and patient guarantors
• Maintain necessary logs
• Answer telephone calls as needed
• Assist with the planning and organization of departmental activities as needed and participate in said activities
• Participate in departmental meetings as necessary.

Requirements:

• 2 years of Medical AR experience
• Thorough knowledge of multi-specialty ICD-9 and CPT coding
• EMR Knowledge