Job Description

Job Description

Job Description

Job Purpose

Under minimal supervision responsible for the daily medical billing, accounts receivable and follow-up for. The Accounts Receivable Specialist’s primary responsibility is to provide the highest quality of customer service and accounts receivable management to our patients. The representative will review and analyze patients’ medical records in conjunction with the accounts receivables to ensure that the claims were billed correctly, and that the insurance company has the necessary information to adjudicate the claims. He/she must be well versed with the insurances and adjudication processes. The representative will follow the prescribed steps in the Insurance Follow-Up Process to ensure that the outstanding A/R is collected within 120 days from the aging date. He/she will accept other duties/projects as assigned. Must be knowledgeable of HIPAA Law, and standard coding such as CPT/HCPCS.

Major Responsibilities

• Prepare and edit medical claims for submission, both hardcopy and electronically, to various third party payors and clearing houses.
• Follow-up and collect outstanding aged trial balance reports, including but limited to oral and written communications. Analyzes and appeals difficult to collect accounts.
• Review and process the daily correspondence to correct or update inquiries from insurance carriers.
• Special projects as assigned.
• Receipt assignment either in the form of manual or electronic entry.
• Post cash received to the system for AR billed accounts or communicate to AP for General Ledger payments for other non-Epic AR sources.
• Assist with the daily reconciliation of bank deposits and cash receipts will be balanced and reported on a daily basis.
• Resolve credit balances and overpayments to facilitate timely refunded of any confirmed overpayments.
• Apply remittances consisting of deposits, credit cards, and checks in a timely and efficient manner.
• Perform, research and initiate resolution of unapplied cash items.
• Apply credits, facilitate and document refund requests.
• Ensures that third party payments posted are in accordance with EMPLOYER payor agreements.
• Functions effectively in a Matrix Management environment.
• Completes any duties and special assignments as requested.
• Ensure all batches posted are appropriately scanned into the correct date and verified.
• Ensure all batches posted balance to the batch deposit total.
• Manage multiple tasks simultaneously, meet deadlines, and exceed goals in medium to high-pressure situations.

Educational Requirements

• High School Diploma or equivalency

Qualifications

• 3-5 years billing experience in a high volume multi-specialty setting, Medicare and or Medicaid billing experience preferred
• CPT and ICD10 coding required
• Type at least 45 WPM
• 10 key proficient
• Computer skills required (Word, Excel, PowerPoint) basic computer knowledge
• Intermediate oral and written communication skills required
• High School Diploma or equivalent

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