Accounts Receivable Specialist

Role Overview

• Analyzing collections, resolving non-payables, and handling bill inquiries for complex issues
• Follow up on claim rejections and denials
• Process assigned AR work lists provided by the manager in a timely manner
• Write appeals to resolve claim denials with a goal of one contact resolution
• Identify and resolve denied, non-paid, and/or non-adjudicated claims
• Recommend accounts to be written off on Adjustment Request
• Check the system for missing payments
• Properly notate patient accounts
• Review correspondence to determine specific problems
• Research patient accounts and determine appropriate follow-up actions
• Process and follow up on appeals
• Respond to insurance company claim inquiries
• Communicate with insurance companies about outstanding claims status
• Meet established production and quality standards
• Perform special projects and other duties as assigned

Requirements

• High School Diploma or GED
• At least one (1) year in the data entry field
• At least one (1) year in medical billing and claims resolution preferred
• AAHAM and/or HFMA certification preferred
• Experience with offshore engagement and collaboration desired
• Intermediate level knowledge of medical billing rules, such as coordination of benefits, modifiers, Medicare, and Medicaid, and understanding of EOBs
• Proficient in the use of billing software within 5 weeks

Benefits

• Ventra performance-based incentive plan
• Referral bonus program