Medical Accounts Receivable Specialist / Remote

Job Description

100% remote, will supply equipment, must be able to work on EST time zone

The AR Follow Up Representative is responsible for completing tasks associated with specific assignments. Specific job responsibilities will be collections, account follow up, billing and allowance posting for the accounts assigned to them. Accounts Receivable Representative I is expected to perform assignment tasks within the quality and productivity standards assigned to position responsibilities.

Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites.

Meets and maintains daily productivity/quality standards established in departmental policies.

Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts.

Adheres to the policies and procedures established for the client/team.

Knowledge of timely filing deadlines for each designated payer.

Performs research regarding payer specific billing guidelines as needed.

Ability to analyze, identify and resolve issues causing payer payment delays.

Ability to analyze, identify and trend claims issues to proactively reduce denials.

Communicates to management any issues and/or trends identified.

Initiate appeals when necessary.

Ability to identify and correct medical billing errors.

Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process.

Understanding of under or over payments and credit balance processes.

Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required.

Act cooperatively and courteously with patients, visitors, co-workers, management and clients.

Work independently from assigned work queues.

Maintain confidentiality at all times.

Maintain a professional attitude.

Other duties as assigned by the management team.

Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Preferred 1+ years’ experience in insurance collections, including submitting and following up on claims for a Medical Practice, Medical Facility/Medical Billing Company, Ambulatory Surgical Center, and/or Hospital or equivalent work experience.

Preferred Physician/Professional Billing: 1+ year or equivalent work experience.

Basic functioning knowledge of the denied claims and appeals process

Basic functioning knowledge of Worker’s Comp and PIP preferred

Basic functioning knowledge of individual payor websites, including, but not limited to, Navinet, Availity and the respective Blue Cross Blue Shield, Medicare and Medicaid sites depending upon the state/s in which the client is located.

Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes

Ability to work well individually and in a team environment

MS Office basic skills. Must have basic Excel skillset

Experience with practice management systems. Preferably EPIC PB, Centricity, Allscripts and/or Cerner

Strong communication skills/oral and written

Strong organizational skills