Accounts Receivable Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Follow up on outstanding claims utilizing monthly aging reports.

• Submit appeals with the necessary documentation to secure maximum reimbursement.

• Maintain precise patient account and billing information.

• Oversee accounts receivable throughout the entire resolution process.

• Submit claims through clearinghouses or directly to payers.

• Monitor, investigate, and resolve claim denials efficiently.

• Communicate with insurance carriers to resolve payment concerns.

• Process claim retractions, write-offs, and contractual modifications.

• Ensure billing information and coding are complete and accurate.

• Verify and record patient and insurance payments to ensure accuracy and compliance with contracts.

• Coordinate secondary billing for patients who have multiple insurers.

• Address inquiries from patients, providers, and insurance entities.

• Assist with incoming calls as needed.

• Verify insurance eligibility and coverage benefits.

• Collaborate with Team Leaders, Section Leaders, and cross-functional teams.

• Escalate issues and promote workflow efficiency.

• Provide excellent customer service to both internal and external stakeholders.

• Comply with HIPAA regulations and protect patient information.

⛳️ Requirements

• High school diploma or GED is required.

• A minimum of 3 years of experience in healthcare billing accounts receivable within a mid-to-large organization.

• Proficient knowledge of CPT and ICD coding.

• Familiarity with basic medical terminology.

• Understanding of insurance guidelines, including Medicare, state Medicaid, and workers' compensation across various states.

• Capability to interpret Explanation of Benefits (EOBs).

• Ability to accurately compute deductibles and coinsurance.

• Commitment to maintaining strict patient confidentiality.

• Exceptional verbal and written communication abilities.

• Strong phone etiquette and customer service skills.

• Capacity to communicate effectively with patients about medical conditions and financial responsibilities.

• Ability to represent the department in a professional manner.

• Proficient in managing service issues tactfully and ensuring appropriate follow-through.

• Proficient in Microsoft Office applications, including Excel and Word.

• Excellent organizational and time management capabilities.

• Proficient in computer systems and typing skills.

• Strong attention to detail and accuracy in mathematics.

• Ability to work collaboratively across various departments.

• Flexibility and openness to new ideas and methods.

• Capacity to remain focused and productive under pressure.

• Willingness to assist colleagues and share pertinent information.

• Preferred: Over 3 years of experience in Healthcare Accounts Receivable with large, complex physician practice groups.

• Preferred: Experience with Electronic Medical Records (EMR) systems, such as Epic or Clinical Works.

• Preferred: Certification as a CPAR or Certified Medical Billing Specialist.

• Preferred: Associate's degree in Healthcare Management, Health Information Management, or a related field.

🏝️ Benefits

• Fully remote work setup.

• Equal employment opportunity.

• Reasonable accommodations provided for qualified individuals with disabilities upon request.