Accounts Receivable Specialist
Job description:
Responsible for managing and resolving open balance accounts. Prepare, submit and follow up on insurance appeals. Expedite follow through for reimbursement. Stays current on insurance policies and procedures.
Reports to:
Billing Manager
Requirements:
High School Diploma or G.E.D. equivalent. One to two years previous working experience with third party payors in medical billing appeal/denial process. Working knowledge of medical billing software and internet. Working knowledge of CPT and ICD-9 coding procedures including CCI, NCD and LCD edits. Basic knowledge of medical terminology. Well organized and detail oriented. Good communication skills, both written and oral.
Please email resume to astephens@originhs.com
Typical physical demands:
- Requires manual dexterity for the manipulation of computer keyboard.
Responsibilities:
- Work open balance accounts as assigned. Prepare and submit appeals on denied charges based on insurance plan requirements. Follow up on unpaid charges and determine best method to collect open balances quickly.
- Make corrections to charges as needed based on medical documentation. (i.e. add modifiers, duplicate denials, correction of date of service, diagnosis corrections.)
- Maintain copies of pertinent documents until resolution of charge(s).
- Respond within seven (7) days to insurance or patient telephone inquiries and correspondence.
- Update account information as needed.
- Review payments against payment schedules for accuracy of allowances.
- Re-post payments and/or charges to accounts, as appropriate.
- Re-submit claims as needed.
- Adjust denied charges with appropriate write-off code, only after gaining Manager/Supervisor approval.
- Participate in educational activities and attend staff meetings.
- Process refunds as necessary according to policies and procedures.
- Correct inaccurate patient addresses as needed.
- Maintain performance standards as determined by Manger/Supervisor
- Make system notes of all action taken on each account.
- Report denial trends preventing payment to Manger/Supervisor weekly, or as needed if critical.
- Promptly report any patient or insurance company complaints requiring Manager/Supervisor attention.
- Keep up to date on insurance policy and procedure changes.
- Adhere to all Origin policies and procedures, including all HIPAA guidelines and regulations.
- Other duties as assigned.