Accounts Receivable Specialist - Medical Billing

JOB FUNCTIONS

• The primary responsibility of the AR Specialist is to actively work assigned clients accounts receivable, and rapidly respond telephone inquiries from patients.
• Works and coordinates with RCM to ensure smooth and efficient operation in all areas of accounts receivable
• Works necessary reports to ensure assigned client AR is actively worked & maintained
• Serves as client/patient support to assigned clients

• ACCOUNTS RECEIVABLE RESPONSIBILITIES
  • Works Denials Daily
    • File Rejected
    • Denial Report
    • In Progress Non-Primary
    • Sent Secondary Crossover

• Review Bad Address report weekly
• • Update patients address in Centricity when report provides updated information
  • Those without new information, send list to practice contact with MRN # advise mail being returned need update, or log-in to EMR, any changes or updates then made to the patients account in Centricity.
• Bill Status Report Hold Charges
  • Reviews charges on hold weekly, and coordinates with charge processor to ensure timely release of charges to avoid untimely filing

• CLAIM SUBMISSIONS/CORRECTIONS
  • Will review, prepare, and submit claims to third party payers (primary and secondary) according to established policies and procedures

• DEMOGRAPHICS
  • Will retrieve, review, verify benefits, and update new insurance information as needed
  • Move demographic files to GeBBs daily for assigned clients
  • Sign-off on Daily Client Charge Log for demographics;
  • Sign-off on Month-end Log by 5th business day of the month

• CORRESPONDENCE
  • Receives and processes miscellaneous correspondence from patients, insurance companies and clients within 48 hours
  • Accounts Receivable follow-up
  • Pulls EOB's

• REFUNDS
  • Will actively review, prepare submit;
    • Refund requests
    • Account adjustments

• COLLECTIONS
• INSURANCE COLLECTIONS

• Run Stop report monthly. The STOP report is used to identify, and facilitate successful collection of both patient and unpaid insurance claims upon completion of patients course of treatment
  • Identify unpaid claims, and set reminders to actively work to a successful conclusion
  • Monitor patient balances, and actively move through collections process including setup payment arrangements

• AGING REPORTS/COLLECTION EFFORTS EXHAUSTED
  • Aging by Financial Class, Patient
  • And any other reports identified to assist in this process by RCM

• PATIENT COLLECTIONS:
  • Will review, prepare and submit patient supplemental bills to patient(s)
  • Assist with payment arrangements
  • Identify Self-pay patients for assigned clients;
  • verify monthly eligibility with Medicaid
  • follow-up with practice charity status
  • Assists in processing credit card payments from patients

• Maintain current list of medical policies for the various procedures, and or diagnosis covered by those entities
• Ensure all corporate guidelines are maintained and practiced daily

• Maintain a "Team Player" attitude at all times
• Communicate professionally with management, Offshore, and peers

• Report Denial Trends to RCM
• Attend AMAC-USA Webinars
• Knowledge of reading and understand an EOB
• Other projects as assigned