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Summary Description:

Accounts Receivable Specialist is responsible for providing timely and efficient follow-up with all payer types for all unpaid claims and presenting data to appropriate parties.

Daily Responsibilities:

• Researches and resolves unpaid, denied, or pending claims and invoices.

• Responsible for the appeal process including filing appeals and monitoring appeals through completion.

• Responsible for accurate information and data input on all patients, insurance, notes, and claims.

• Generates invoices for client billing.

• Negotiates with the responsible party on unpaid accounts.

• Assists in identifying potential billing issues.

• Participates in staff meetings and offers appropriate and constructive suggestions and criticism.

• Utilizes any extra time during decreased workload to assist other employees that may have extra workloads.

• Organizes work in a manner to keep up with all the details of the job requirements.

• Demonstrates competency in skills and knowledge pertinent to the practice of accounts receivable.

• Demonstrates working knowledge of insurance carrier rules and regulations as pertaining to reimbursement.

• Consistently performs routine tasks in an independent manner, while exercising good judgment during those instances when help may be needed, or a supervisor needs to be informed.

• Other duties as assigned.

Required Skills

• Seeks continual professional development by updating current knowledge base regarding private insurance reimbursements.

• Utilizes proper chain of command when addressing concerns or problems.

• Proficient computer skills with Microsoft Excel.

• Excellent Communication (Verbal & Written) Skills.

• Data entry skills.

• Strong work ethics and confidentiality.

• Time management skills and attention to detail.

Required Experience

+ High school diploma or equivalent

+ 2 + years of relevant healthcare AR and denials experience required.

+ Experience working with claims billing preferable.