JOB SUMMARY:

•  The Medical AR Follow Up Specialist is responsible for identification of systems and operations issues that affect billing and accounts receivable performance and makes recommendations for process enhancements to management.
• Uses GE business intelligence standard and ad hoc reports providing supporting data.
• Provides cross-coverage for job duties during extended staff absence, vacancy or departmental business need including but not limited to Billing Specialist, Recovery I, Recovery II, Payment Posting and Credit Specialist positions.
• Provides analytical support to maximize recoveries on Accounts Receivables and proactively identifies areas that require attention to protect a positive cash position.
• Displays the ability to be flexible, multitask and perform a variety of duties as requested by management

REQUIREMENTS:

• Formal working knowledge; equivalent to an Associate's degree (2 years college); requires knowledge of a specialized field
• 5 years of medical AR follow up experience

ADDITIONAL COMMENTS: 

Extensive Knowledge of all aspects of insurance including Managed Care, Commercial Insurance, Medicare and Medicaid products. Understands and adheres to state and federal regulations, HIPAA and PHI guidelines. Responsible for a broad range of collection processes related to medical accounts receivable and ensure a proactive approach to maximize and achieve accurate and timely payment. Extensive knowledge in reviewing account balances after payments are applied including all overpayment and underpayment accounts and routinely communicate with payers on all outstanding balances. Strong attention to detail is a must. Extensive knowledge of CPT and ICD 10 coding guideline. Strong ability to work in contract management systems to review and appeal underpayments and denials