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Accounts Receivable Specialist
Job Location US-Remote | US
ID 2022-1981
Category
Operations
Position Type
Regular Full-Time
Job Summary:
Accounts Receivable (“AR”) Specialists are primarily responsible for analyzing collections, resolving non-payables, and handling bill inquiries for more complex issues. AR Representatives are responsible for insurance payer follow-up ensuring claims are paid according to client contracts. Complies with all applicable laws regarding billing standards.
Responsibilities
Essential Functions and Tasks:
- Follows up on claim rejections and denials to ensure appropriate reimbursement for our clients
- Process assigned AR work lists provided by the manager in a timely manner
- Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution
- Identified and resolved denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizations
- Recommend accounts to be written off on Adjustment Request
- Reports address and/or filing rule changes to the manager
- Check system for missing payments
- Properly notates patient accounts
- Review each piece of correspondence to determine specific problems
- Research patient accounts
- Reviews accounts and to determine appropriate follow-up actions (adjustments, letters, phone insurance, etc.)
- Processes and follows up on appeals. Files appeals on claim denials
- Scan correspondence and index to the proper account
- Inbound/outbound calls may be required for follow up on accounts
- Route client calls to the appropriate RCM
- Respond to insurance company claim inquiries
- Communicates with insurance companies for status on outstanding claims
- Meet established production and quality standards as set by Ventra Health
- Performs special projects and other duties as assigned
Qualifications
Education and Experience Requirements:
- High School Diploma or GED
- At least one (1) year in data entry field and one (1) year in medical billing and claims resolution preferred
- AAHAM and/or HFMA certification preferred
- Experience with offshore engagement and collaboration desired
Knowledge, Skills, and Abilities (KSAs):
- Intermediate level knowledge of medical billing rules, such as coordination of benefits, modifiers, Medicare, and Medicaid and understanding of EOBs
- Become proficient in use of billing software within 4 weeks and maintain proficiency
- Ability to read, understand, and apply state/federal laws, regulations, and policies
- Ability to communicate with erse personalities in a tactful, mature, and professional manner
- Ability to remain flexible and work within a collaborative and fast paced environment
- Basic use of computer, telephone, internet, copier, fax, and scanner
- Basic touch 10 key skills
- Basic Math skills
- Understand and comply with company policies and procedures
- Strong oral, written, and interpersonal communication skills
- Strong time management and organizational skills
- Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills