Accounts Receivable Specialist

Role Overview

• Responsible for all areas of the revenue management life cycle
• Ensures necessary information critical to submitting clean claims is obtained
• Perform eligibility and benefit checks
• Minimize bad debt by ensuring timely follow-up of unpaid claims, resolution of denials, and other payer-related correspondence
• Research, appeal, and resolve claim rejections, underpayments, and denials with appropriate payer
• Reviews and interprets payer remittances to determine appropriate action to be taken on denied claims
• Identify root cause of claim exceptions; resolve and/or escalate issues
• Analyzes outstanding account balances and determines plan of action to resolve
• Determine and apply appropriate business action in absence of policies or in cases of ambiguity
• Identifies and interprets policies related to exceptions
• Contacts payers for status of unpaid claims
• Maintains knowledge/understanding of third party payer regulations for managed care, Medicare, and Medicaid accounts
• Maintains patient confidentiality according to compliance policies and HIPAA

Requirements

• Medical billing, denial management and collections experience required
• High degree of problem solving abilities required

Benefits

• comprehensive medical coverage
• life and disability insurance
• 401(k) with company match
• paid holidays and vacation
• personal days
• dental and vision options