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This position is located at the Birmingham Business Office
Summary: Under general supervision, an AR Account Follow-Up Specialist is responsible for account follow-up for all assigned accounts, resolving billing problems and answering patient inquiries. Uses collection techniques to keep accounts receivable current including monitoring for delinquent payments. The Account Follow-Up Specialist will review insurance claims and take the appropriate action, including completion of submissions, reconsiderations, appeals, or re-working denials, to ensure payment is received timely.
Essential Duties and Responsibilities:
- Performs audits of patient accounts to ensure accuracy and timely payment.
- Reviews account aging monthly and reports inconsistencies and correct errors as appropriate.
- Follows up on insurance billing to ensure timely receipt of payments.
- Demonstrates the ability to deal with patients and insurance companies regarding sensitive financial matters and recapture unpaid balances.
- Receives and resolves patient billing complaints and questions; initiates adjustments as necessary; follows up on all zero payment explanations of benefits and exercises all options to obtain claim payments.
- Reviews credit balance reports for correct recipient of refund.
- Performs reconciliation of refund accounts; attaches documentation and forwards to supervisor to process refund checks.
- Identifies problems on accounts and follows through to conclusion.
- Responds to insurance companies requests for information in a prompt and professional manner.
- Reviews appropriate files to identify deceased patients and estates; verifies dollar amounts and files estate to appropriate court in a timely manner.
- Reviews EOBs to ensure proper reimbursement of claims and reports any problems, issues, or payor trends to supervisor.
- Resubmits insurance claims within 72 hours of receipt.
- Participates in maintaining Payor Manuals/Profiles.
- Works closely with collection agency to assure that they receive updated information on accounts as necessary.
- Prepares write-off requests with appropriate documentation and submits to supervisor.
- Processes insurance/patient correspondence, including denial follow-up within 48 hours of receipt. Files all reimbursement correspondence daily.
- Works with provided aging to monitor patient account aging and follows up appropriately.
- Maintains confidentiality in regard to patient account status and the financial affairs of clinic/corporation.
- Other relevant duties as assigned
- Must possess a comprehensive knowledge of revenue cycle functions and systems, physician practice revenue cycle operations, revenue metrics and analytics.
- Must have strong management and leadership skills that emphasize team building and collaboration. Not afraid to jump in and help with backlogs or projects.
- Excellent communications skills, written and verbal with ability to provide clear direction to staff as well as presentation skills.
- Proficient with computers and their applications including EMR’s, Practice Management systems, databases, and Microsoft Office products such as Outlook, Excel, and Word.
- Have a track record of leadership success in healthcare revenue cycle management.
- Demonstrated knowledge of the federal, state, and local regulatory requirements around medical billing and coding as well as CMS and payer regulations.
- Ability to work independently.
- Able to manage multiple projects at once, ability to work efficiently and effectively under tight deadlines.
- Demonstrates advanced analytical, evaluative, problem solving and decision-making, fostering innovative approaches to situations/processes/issues.
- Strong collaborative leadership qualities, willing to work side by side with staff when “hands on” approach is needed.
- Experience in a complex healthcare organization preferred with oncology experience highly desirable.
Requirements - Bachelors (preferred) in healthcare, accounting or related field or a high school graduate
- 3 plus years of experience
- Experience in medical billing /insurance processing and balancing accounts
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