Position Summary
The Senior Accounts Receivable Specialist performs resolution oriented activities with a focus on comprehensive medical billing, payment posting, and 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 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 within all areas of the departmentPayment Posting: EFT, credit card, ACH, live check and insurance paymentsResearches and evaluates insurance payments and correspondence for accuracyHigh volume 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, & tertiary payers and/or patient statementsReview rejected claims, perform correction activities and ensure resubmission as appropriateProcess the billing and payment for all Veterans Affairs purchase orders and provide required documentation to the purchasing agent within the contracted timeframeEnsure 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 the Revenue Cycle Manager or Team Lead to ensure consistent and efficient department process.Ensure 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 other members of the teamSupports team members with problem resolution in Management's absenceComply 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 assigned
Powered by JazzHR
Equal employment opportunity, including veterans and individuals with disabilities.
PI264533753
