Accounts Receivable Associate Specialist is responsible for following up directly with commercial, governmental, and other payers to resolve claim payment issues.
Identifies and analyzes denials, payment variances, and no response claims and acts to resolve claims/accounts, including drafting and submitting technical and clinical appeals.
Provides support for all denial, no response, and audit activities.
Examines denied and other non-paid claims to determine the reason for discrepancies.
Communicates directly with payers to follow up on outstanding claims, files technical and clinical appeals, resolves payment variances, and ensures timely and accurate reimbursement.
Works with management to identify, trend, and address root causes of issues in the A/R.
Documents all activity accurately including contact names, addresses, phone numbers, and other pertinent information in the client’s host system and/or appropriate tracking system.
Requirements
Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel.
Excellent Verbal skills.
Problem solving skills, the ability to look at accounts and determine a plan of action for collection.
Critical thinking skills, the ability to comprehend tools provided for securing payment, and apply them to differing accounts to result in payment.
Adaptability to changing procedures and growing environment.
Meet quality and productivity standards within timelines set forth in policies.
Meet required attendance policies.
Preferred: 2 or 4-year college degree.
Preferred: 1 or more years of relevant experience in medical collections, physician/hospital operations, AR Follow-up, denials & appeals, compliance, provider relations or professional billing preferred.
Preferred: Knowledge of claims review and analysis.
Preferred: Working knowledge of revenue cycle.
Preferred: Experience working the DDE Medicare system and using payer websites to investigate claim statuses.
Preferred: Working knowledge of medical terminology and/or insurance claim terminology.