Accounts Receivable Specialist

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

📋 Description

• Conduct follow-ups on outstanding claims utilizing monthly aging reports and file appeals to secure optimal reimbursement.

• Ensure precise account and billing information, encompassing patient, guarantor, insurance, procedure, and payment details.

• Oversee accounts receivable from initiation to full resolution.

• Submit claims through clearinghouses or directly to payers.

• Monitor, investigate, and address claim denials and payment discrepancies.

• Communicate with insurance carriers and submit appeals with the necessary documentation.

• Process claim retractions, write-offs, and contractual adjustments in line with payer guidelines.

• Review and apply insurance and patient payments while managing secondary billing.

• Respond to inquiries from patients, providers, and insurance companies and assist with incoming calls.

• Verify insurance eligibility and coverage benefits.

• Collaborate with Team Leaders, Section Leaders, and cross-functional teams to escalate issues and enhance workflow efficiency.

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

• Comply with HIPAA regulations and protect patient information.

⛳️ Requirements

• High school diploma or GED.

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

• Proficient understanding of CPT and ICD coding.

• Familiarity with basic medical terminology.

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

• Ability to interpret Explanation of Benefits (EOBs).

• Competence in accurately calculating deductibles and coinsurance.

• Capacity to maintain strict confidentiality of patient information.

• Excellent verbal and written communication skills.

• Strong phone etiquette and customer service abilities.

• Capability to effectively communicate with patients regarding medical conditions and financial obligations.

• Skill in addressing service issues with professionalism and tact.

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

• Strong organizational and time management skills.

• Competence in computer systems and typing.

• Keen attention to detail, particularly in mathematical accuracy.

• Ability to work collaboratively across departments.

• Flexibility and receptiveness to new ideas and methods.

• Ability to maintain focus and productivity under pressure.

• Compliance with HIPAA regulations and safeguarding of patient information.

• Preferred: 3+ years of Healthcare AR experience with extensive physician practice groups.

• Preferred: EMR experience on at least one platform, such as Epic or Clinical Works.

• Preferred: CPAR certification.

• Preferred: Certified Medical Billing Specialist certification.

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

🏝️ Benefits

• Fully remote work arrangement.

• Equal Employment Opportunity.

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