Position Summary
The Accounts Receivable Specialist performs resolution oriented activities with a focus on comprehensive medical billing, payment posting, and/or collection actions. While ensuring compliance with relevant laws, regulations and established company policies and compliance programs this role is responsible for efficient cash collections through excellent reimbursement practices, accurately posting of EFT, credit card, ACH and check insurance/patient payments, and/or performing accurate claim billing.
Essential Duties and Responsibilities
The essential functions may include, but are not limited to the following:Supports and/or performs daily duties as assigned in one or multiple areas of the department which include:Payment Posting: EFT, credit card, ACH, live check and insurance paymentsResearches and evaluates insurance payments and correspondence for accuracyAccurate processing and posting of insurance and patient paymentsMatches EOB and payment records with paymentsProcessing write offs according to company policyBatching and scanning of payments to ensure records are on fileMay assist with administrative duties fundamental to successful posting or project operationsBilling: Accurate and timely submission of all claims for all payersDaily claim/invoice submission for primary, secondary and tertiary payers and/or patient statementsReview rejected claims, perform correction activities and ensure resubmission as appropriateEnsure all Contract Billing Partner billing is submitted to appropriate outsourced partnerCollections: Timely and accurate follow up on unpaid claims or patient accountsWork assigned lists of outstanding claim balances and/or patient accounts with multifaceted issues across different payers and patientsIdentify trends, conduct follow up and perform root cause analysis on unpaid and underpaid insurance claims across different payersAnalyze and resolve billing discrepancies on patient accounts. Ability to explain findings to patientUse persuasive written and oral communication skills to draft appeals and effectively overturn denied or underpaid claimsPerform actions towards remediation of outstanding balances according to policy and procedure; including but not limited to, in depth research appeals, rebilling, calling the payer or clinic, and utilizing payer portalsIdentify and communicate issues or trends to department management ensuring consistent and efficient department processEnsure adherence with federal regulatory timeframes for handling cases including acknowledging cases, resolving cases, monitoring effectuation of resolution, completing resolution letters and communicating with members and providers within required time framesWork collaboratively within the team and with other departmentsBe a positive role model willing to share knowledge, skills and expertise with all members of the teamComply with all HIPAA and privacy regulationsAdhere to laws and best practices in regards to dealing with patients and patient dataPerform other job-related duties as assignedMinimum Qualifications (Knowledge, Skills, and Abilities)High School Diploma or GED required, college degree preferredExperience with claim submission, payment posting, appeal and denial processes; minimum 1 year requiredExperience in medical device billing and/or general healthcare reimbursement, minimum 1 year requiredUnderstanding of healthcare methodologies (coding, coverage, criteria, payments)Able to work collaboratively and cross-functionally with other departments to facilitate appropriate resolutionsExcellent problem solving and analytical skills, requiredAbility to prioritize work and analyze workflow deficiencies to improve processesAbility to consistently meet appeals accuracy and timeline requirements by achieving regulatory standardsMust have good computer skills, experience with Microsoft Office, requiredAble to communicate clearly, both orally and in writingAble to work effectively with a wide range of peopleTime management skillsExcellent organizational skills and attention to detailPhysical Demands and Work Environment
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.Must be able to work onsite at our corporate headquarters in Maryland Heights, MOMust be able to work in an office setting, use a computer, keyboard and mouse for the majority of the shift and be able to communicate on the telephoneMust be able to work the scheduled 8 hour shift Monday-FridayWork from home is available at supervisors discretion and as business needs allow, in accordance with the BioTAB Work From Home Policy
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