Accounts Receivable Specialist

Accounts Receivable Specialist

Effectively manage the accounts receivable process to ensure timely and accurate payments and the proper posting of payments for all accounts.

Key Duties/Responsibilities

1.Technical Capabilities: Operate a variety of standard office machines, including a personal computer and a variety of computer software, multi-line phone system, fax, calculator, shredding machine, and photocopy machine. Responsible for the accurate posting of payments into the practice management system.

2.Account Review: Will be required to review patient accounts, including history, patient notes, payments, demographics etc. to understand the accounts financial standing and to resolve any issues that may be present.

3.Phone Skills: Handle all inbound phone calls in relation to account status from patients, insurance companies, and other interested parties in a timely manner. Also responsible to place outbound calls to insurance companies for claim status, claims appeals, and to gain additional information that may be needed on an account. Will also be required to place outbound calls to patients to discuss account activity and to collect outstanding amounts or set up financial arrangements.

4.Evaluation of the EOR: Responsible to review all EOR’s to determine claim was paid according to contract terms and expected patient benefit levels. If discrepancy occurs, investigate until resolution occurs. This includes paper and electronic EOR’s.

5.Trend Detection: Responsible for evaluating errors and determining if the issue detected is something that may be a trend of errors that needs further investigating. Responsible to bring all serious trend issues to managements attention immediately.

6.Pend System: Manage the pend process by working pends to resolution (or next step) on or before the due date assigned to the pend. Required to make recommendations to office manager on claims that should be sent to collections or written off. Will be responsible for sending to collection agency once approval is received.

7.Posting of Payments: Responsible for posting all incoming receivables and denials to patient accounts in and efficient and timely manner. This includes suspension and un-suspension of payments as needed.

8.Documentation: Clear and concise documentation is required for all activities performed in this role.

9.Refunds: Responsible for handling all patient and insurance company refunds that are necessary once the claim is fully adjudicated. Includes managing suspended payments to resolution.

10.Manage Accounts Receivable Days: Responsible to minimize any accounts outstanding more than 90 days. This includes monitoring reporting, follow up on outstanding claims, and working claims to resolution. This also includes delegating where appropriate to the Accounts Receivable Analyst (ARA) when necessary and to support the ARA when needed to maintain accounts under 90 days.

11.New Mail: Required to review and respond to all coorespondence in relation to patient accounts. This includes EOR’s, requests for more information, coorespondence from patients about their accounts, etc.

12.Invoice Requests: Required to create invoices upon request for insurance companies that process based on invoice for particular items.

13.Balance Batches: Ensure batches balance and work is completed by 4:30 p.m. daily.

14.HIPAA Compliance: Perform all functions in compliance with HIPAA and State Regulations.

15.Communication: Responsible for communicating status of accounts receivable and any issues detected to management on a timely basis. Also expected to communicate process improvement ideas to continually improve the process to gain efficiencies. Communication between co-workers, especially the ARA, will be critical to the success of this position.

16.Secondary Billing: Generate a bill to carriers when required (rebill, secondary payers etc.).
REQUIREMENTS
1.High school diploma or GED required
2.Three years of health insurance background or provider office accounts receivable experience, or a combination, required.
3.Previous basic computer experience required
4.Prefer experience with Electronic Claims submission processes (preferably Netwerkes.com).
5.Prior knowledge and experience working with Durable Medical Equipment including orthotics and prosthetics preferred.