Accounts Receivable Specialist

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

📋 Description

• Monitor outstanding claims by utilizing monthly aging reports.

• Submit appeals accompanied by the necessary documentation to secure maximum reimbursement.

• Ensure the accuracy of patient, guarantor, insurance, account, and billing information.

• Oversee accounts receivable through complete lifecycle resolution.

• Dispatch claims through clearinghouses or directly to payers.

• Track, investigate, and resolve claim rejections.

• Liaise with insurance carriers to resolve payment discrepancies.

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

• Guarantee claim precision and compliance by inputting billing, diagnosis, procedure, modifier, and provider details.

• Validate insurance payments for correctness and adherence to contracts.

• Record insurance and patient payments within billing systems.

• Coordinate secondary billing for patients with multiple insurance providers.

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

• Assist with incoming calls as required.

• Verify insurance eligibility and benefits coverage.

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

• Provide updates, escalate concerns, and enhance workflow efficiency.

• Deliver outstanding customer service to both internal and external stakeholders.

• Comply with HIPAA regulations and protect patient information.

⛳️ Requirements

• High school diploma or GED is mandatory.

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

• Preferred: Over 3 years of healthcare accounts receivable experience with large, complex physician practice groups.

• Preferred experience with EMR systems across at least one platform, such as Epic or Clinical Works.

• Preferred certification as a Certified Patient Account Representative (CPAR).

• Preferred certification as a Certified Medical Billing Specialist.

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

• Familiarity with CPT and ICD coding.

• Basic understanding of medical terminology.

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

• Capability to interpret and comprehend Explanations of Benefits (EOBs).

• Skill in accurately calculating deductibles and coinsurance.

• Commitment to maintaining strict patient confidentiality.

• Exceptional verbal and written communication abilities.

• Strong phone etiquette and customer service skills.

• Proficiency in effectively communicating with patients about medical issues and financial obligations.

• Ability to professionally represent the department in interactions with patients, guests, physicians, and staff.

• Capacity to handle service issues with tact and professionalism, ensuring appropriate follow-up.

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

• Excellent organizational and time management skills with the ability to prioritize tasks effectively.

• Competence in computer systems and typing.

• Keen attention to detail, including mathematical precision.

• Ability to work collaboratively across various departments.

• Openness to new ideas and approaches.

• Capability to remain focused and productive under pressure.

• Must adhere to HIPAA regulations and protect patient information.

• Ability to lift, carry, push, or pull materials, supplies, and equipment weighing up to 10 lbs.

• Travel may be necessary.

• May require safety equipment for infection control.

🏝️ Benefits

• Fully remote work arrangement.

• Equal employment opportunity.

• Reasonable accommodations for qualified individuals with disabilities.

• Travel may be required, including travel between Company locations and to out-of-town destinations as necessary.

• Safety equipment may be provided or required for infection prevention.