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This position is located at the Birmingham Business Office

Summary: Under general supervision, an AR Account Follow-Up Specialist is responsible for account follow-up for all assigned accounts, resolving billing problems and answering patient inquiries. Uses collection techniques to keep accounts receivable current including monitoring for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take the appropriate action, including completion of submissions, reconsiderations, appeals, or re-working denials, to ensure payment is received timely.

Essential Duties and Responsibilities:

+ Performs audits of patient accounts to ensure accuracy and timely payment.

+ Reviews account aging monthly and reports inconsistencies and correct errors as appropriate.

+ Follows up on insurance billing to ensure timely receipt of payments.

+ Demonstrates the ability to deal with patients and insurance companies regarding sensitive financial matters and recapture unpaid balances.

+ Receives and resolves patient billing complaints and questions; initiates adjustments as necessary; follows up on all zero payment explanations of benefits and exercises all options to obtain claim payments.

+ Reviews credit balance reports for correct recipient of refund.

+ Performs reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks.

+ Identifies problems on accounts and follows through to conclusion.

+ Responds to insurance companies requests for information in a prompt and professional manner.

+ Reviews appropriate files to identify deceased patients and estates; verifies dollar amounts and files estate to appropriate court in a timely manner.

+ Reviews EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends to supervisor.

+ Resubmits insurance claims within 72 hours of receipt.

+ Participates in maintaining Payor Manuals/Profiles.

+ Works closely with collection agency to assure that they receive updated information on accounts as necessary.

+ Prepares write-off requests with appropriate documentation and submits to supervisor.

+ Processes insurance/patient correspondence, including denial follow-up within 48 hours of receipt. Files all reimbursement correspondence daily.

+ Works with provided aging to monitor patient account aging and follows up appropriately.

+ Maintains confidentiality in regard to patient account status and the financial affairs of clinic/corporation.

+ Other relevant duties as assigned

+ Must possess a comprehensive knowledge of revenue cycle functions and systems, physician practice revenue cycle operations, revenue metrics and analytics.

+ Must have strong management and leadership skills that emphasize team building and collaboration. Not afraid to jump in and help with backlogs or projects.

+ Excellent communications skills, written and verbal with ability to provide clear direction to staff as well as presentation skills.

+ Proficient with computers and their applications including EMR's, Practice Management systems, databases, and Microsoft Office products such as Outlook, Excel, and Word.

+ Have a track record of leadership success in healthcare revenue cycle management.

+ Demonstrated knowledge of the federal, state, and local regulatory requirements around medical billing and coding as well as CMS and payer regulations.

+ Ability to work independently.

+ Able to manage multiple projects at once, ability to work efficiently and effectively under tight deadlines.

+ Demonstrates advanced analytical, evaluative, problem solving and decision-making, fostering innovative approaches to situations/processes/issues.

+ Strong collaborative leadership qualities, willing to work side by side with staff when “hands on” approach is needed.

+ Experience in a complex healthcare organization preferred with oncology experience highly desirable.

Requirements

+ Bachelors (preferred) in healthcare, accounting or related field or a high school graduate

+ 3 plus years of experience

+ Experience in medical billing /insurance processing and balancing accounts

Company Benefits

+ Family/Work balance Monday - Friday work schedule

+ Company Holidays

+ Company Vacation

+ Excellent Medical with vision included.

+ Excellent Dental

+ Free parking

EOE