What are the responsibilities and job description for the Accounts Receivable Specialist position at Advanced Urology Institute?
GENERAL SUMMARY
The Accounts Receivable Specialist is responsible for all steps in resolving patient account balances with insurance payers. This process includes working online with payer websites for inquiries and telephone follow up with the payers to ensure proper reimbursement is received for provider services billed. The specialist will review medical records for appropriate documentation inclusive of correct CPT and payable ICD-10 codes before sending to payer, file necessary appeals or other miscellaneous steps to ensure payment.
Requirements
ESSENTIAL JOB FUNCTION / COMPETENCIES
Responsibilities include but are not limited to :
- Provides support services both on the telephone and in office as applicable for patients and authorized representatives regarding patient accounts.
- Follows up on all outstanding insurance claims at 60 days from the date of billing following established guidelines.
- Provides information pertaining to billing, coding, managed care networks, insurance carriers and reimbursement to providers, client staff and co-workers.
- Follows up on all returned claims, correspondence, denials, account reconciliations and rebills to achieve maximum reimbursement in a timely manner with emphasis on timely resolution.
- Recommends accounts for adjustments following department guidelines.
- Monitors reimbursement from managed care networks and insurance carriers to ensure reimbursement consistent with contact rates.
- Answers inquiries from client staff regarding billing issues.
- Uses payer web sites and eligibility portals to check claim status and to efficiently conduct accounts receivable follow up to maximize revenue.
- Adhere to all policies related to HIPAA and Medicare compliance.
- Performs other position related duties as assigned.
- Employees shall adhere to high standards of ethical conduct and will comply with and assist in complying with all applicable laws and regulations. This will include and not be limited to following the Solaris Health Code of Conduct and all Solaris Health and Affiliated Practice policies and procedures; maintaining the confidentiality of patients' protected health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA); immediately reporting any suspected concerns and / or violations to a supervisor and / or the Compliance Department; and the timely completion the Annual Compliance Training.
CERTIFICATIONS, LICENSURES OR REGISTRY REQUIREMENTS
KNOWLEDGE | SKILLS | ABILITIES
EDUCATION REQUIREMENTS
EXPERIENCE REQUIREMENTS
REQUIRED TRAVEL
PHYSICAL DEMANDS
Carrying Weight Frequency
1-25 lbs. Frequent from 34% to 66%
26-50 lbs. Occasionally from 2% to 33%
Pushing / Pulling Frequency
1-25 lbs. Seldom, up to 2%
100 lbs. Seldom, up to 2%
Lifting - Height, Weight Frequency
Floor to Chest, 1 -25 lbs. Occasional : from 2% to 33%
Floor to Chest, 26-50 lbs. Seldom : up to 2%
Floor to Waist, 1-25 lbs. Occasional : from 2% to 33%
Floor to Waist, 26-50 lbs. Seldom : up to 2%
