Medical Accounts Receivable Specialist

Bridge Dermpath is a fast-growing, physician-owned practice located in Tarrytown, NY that specializes in the field of dermatopathology. We are seeking a highly skilled and detail-oriented Medical Insurance Billing Collector to join our growing healthcare organization. The ideal candidate will have a proven track record of managing medical claims, recognizing various denial types from different insurance payers, and utilizing effective strategies to work through denials and maximize collections. This role requires a strong understanding of the insurance billing process, payer-specific requirements, and best practices to enhance revenue cycle performance.

This position is full-time with a work schedule of Monday through Friday from 9:00 AM until 5:30 PM.

Position Overview: As a Medical Accounts Receivable Specialist, you will play a crucial role in managing and optimizing the accounts receivable process for our laboratory. Your expertise will contribute to the overall financial health of our organization, ensuring timely collections and accurate billing.

Key Responsibilities:

• Claims Denial Management: Review, identify, and analyze denied claims from insurance companies. Determine the appropriate steps to take for each denial type, including coding discrepancies, authorization issues, patient eligibility concerns, and billing errors.
• Appeals: Prepare and submit timely, accurate appeals to insurance carriers, addressing denials effectively and ensuring that claims are reprocessed promptly. Work directly with insurance companies to resolve disputes and gather necessary documentation to support claim appeals.
• Collaborate with payers to negotiate claim resolutions and payments. Address outstanding payment issues, reduce claim lag time, and actively work towards maximizing recovery on underpaid claims.
• Payment Follow-Up & Collections: Monitor aging accounts receivable and follow up on outstanding balances from insurance companies. Develop and maintain relationships with payer representatives to expedite claim resolution and ensure timely payments. Ensure all collections are properly documented and tracked.
• Account Reconciliation: Review and reconcile accounts to ensure that payments and adjustments have been applied correctly. Investigate and resolve any discrepancies in patient balances, insurance payments, or contractual adjustments.
• Knowledge of Denial Codes & Payer Guidelines: Stay up to date with industry trends, payer-specific denial codes, and best practices for managing claim rejections. Recognize common denial reasons, such as authorization issues, eligibility problems, coding mistakes, and payer-specific requirements.
• Data Entry & Documentation: Accurately document all communication, actions taken, and status updates in the system. Maintain detailed notes on each claim and account to ensure transparent and effective follow-up processes.
• Collaboration: Work closely with other departments, including the coding team, patient billing, and clinical staff, to resolve issues and ensure that all necessary documentation is in place for successful claim submission and payment.

Qualifications:

• High School diploma or equivalent
• Experience: Minimum of 3-5 years of experience in medical billing and collections, with a focus on insurance denials, payer-specific protocols, and account resolution. Experience with a variety of insurance payers (commercial, Medicaid, Medicare, etc.) is required.
• Denial Management Expertise: In-depth knowledge of insurance claim denial codes, appeal processes, and payer-specific billing requirements. Demonstrated ability to resolve complex denials and efficiently recover payments.
• Knowledge of Insurance and Healthcare Terminology: Strong understanding of healthcare billing, coding (CPT, ICD-10, HCPCS), insurance payer practices, and reimbursement guidelines. Familiarity with the different types of insurance payers, including government programs and private insurers.
• Analytical Skills: Ability to analyze claim denial patterns and develop actionable strategies to address recurring issues. Excellent problem-solving skills and attention to detail.
• Communication Skills: Excellent written and verbal communication skills to interact with insurance representatives, patients, and internal teams. Ability to write clear, concise appeals and rebuttals to insurance companies.
• Familiarity with payer portals, claims management systems, and Microsoft Office (Excel, Word) is essential.
• Organizational Skills: Strong ability to prioritize tasks, manage time effectively, and handle a high-volume workload. Must be able to follow up on multiple accounts simultaneously while maintaining accuracy and attention to detail.

Bridge Dermpath provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Hourly wage is dependent on a variety of factors, including experience, specialty, and education.

Job Type: Full-time

Pay: $24.50 - $33.00 per hour

Benefits:

• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• Medical billing: 3 years (Required)

Work Location: In person

Salary : $25 - $33