Accounts Receivable Specialist
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Job Description
Accounts Receivable Specialist overseeing outstanding medical claims processing at CommUnityCare Health Centers. Requires strong experience in accounts receivable and effective communication with insurers.
Responsibilities:
- Contact insurance carriers on a daily basis to follow up on/collect past due amounts on outstanding medical claims regarding denials or benefit changes.
- Maintain an accurate, up to date aging of assigned accounts including AR analysis and follow up.
- Keep educated on billing and medical policies for all payers.
- Have a working knowledge of In and Out of Network reimbursement processes/methodologies.
- Create and follow up on appeals needed to protest denials or incorrect payments.
- Review complex denials/tasks assigned by the payment posting team and resolve accordingly including reviewing refund requests, disputes and appeal as necessary.
- Work across all RCM departments to get issues related to claims payment resolved.
- Uphold and ensure compliance and attention to all company policies and procedures as well as the overall mission and values of the organization.
- Work with AR Supervisor to review/resolve open accounts as assigned.
- Perform other duties as assigned.
Requirements:
- Minimum Education: High School Diploma or GED
- Minimum Experience: 3 years of experience managing Accounts Receivable and performing direct follow up with payers.
- 1 year experience communicating effectively, both orally and in writing, with insurance payers and internal company communications.
- 3 years working with medical terminology, ICD10, CPT, HCPCs coding and HIPAA requirements.
- 2 years of experience with data processing and analytical skills, proficiency in Excel and Microsoft Office Suite as well as medical practice management software and electronic medical records.
- 3 years of experience working with commercial, government and state insurance payers and their reimbursement policies and procedures.
- 3 years' experience working complex insurance issues, including assigning correct payer, EOB adjustments and refunds to accounts.
Benefits:
- Health insurance
- Retirement plans
- Paid time off
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