Healthcare Accounts Receivable Specialist
The primary responsibility of medical accounts receivable managers is to oversee a healthcare facility’s billing department. They must ensure that patients and insurance companies are properly billed for all services, and that payments are received and processed in a timely manner.
Essential Responsibilities
- Telephone insurance carrier/patient to seek resolution on account
- Resolve inappropriate payments with insurance carriers that are not in compliance with payer contracts or governmental agency rates on individual accounts
- Utilize specialized knowledge of contracts, regulatory or contractual billings guidelines to determine an account’s ability to pay after initial rejection from payer
- Coordinate duplicate billings, coordination of benefits, medical records or clinical documents as needed to expedite payment of insurance claims
- Identify trends in payer non-compliance and inform management if not able to resolve with payer
- Negotiate within specified guidelines with payers
- Ensure secondary carrier is appropriately billed or self-pay portion is pursued
- Determine an individual’s ability to pay and seeks additional assistance either through governmental programs or uncompensated care programs
- Follows up with appropriate staff to locate missing information
- Ensure accurate and timely billing of all outstanding account balances to the appropriate third-party payers and patient guarantors
- Maintain necessary logs
- Answer telephone calls as needed
- Assist with the planning and organization of departmental activities as needed and participate in said activities
- Participate in departmental meetings as necessary.
Requirements
- 2 years of Medical AR experience
- Thorough knowledge of multi-specialty ICD-9 and CPT coding
- EMR Knowledge
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