AR Specialist

Summary

Account Receivable Specialists are responsible for preparing and processing claims, including adjustments for submission to primary, secondary, and tertiary insurance companies. Receives and applies payments to patients' accounts. Represents EHN in a professional manner at all times.

Supervisory Responsibilities

This position does not have supervisory responsibility but will provide guidance to employees and/or assist with orientation and training of new employees of the work group.

Primary Duties And Responsibilities

• Process charges that are directly billed to medical and vision insurers, review and process paper and electronic claims daily.
• Calculate, prepare, and issue bills, invoices, account statements and other financial records according to established procedures.
• Review and research all patient accounts for adequate third-party billing details.
• Audit insurance claims for accurate charges, ICD10 and CPT codes and contractual requirements; identifies and resolves coding discrepancies.
• Investigate, resolve and process claim denials; correct claims denied by electronic edits and resubmits according to the insurance payer guidelines.
• Receive payments and post amounts paid to patient accounts.
• Locate and monitor overdue accounts.
• Respond to and research patient inquiries regarding accounts; provide superior customer service at every interaction.
• Ensure patient account information is updated in a timely manner, including all patient data and insurance information, purge records of deceased patients.
• Coordinate work with clinic staff to ensure accurate and thorough patient data and claim information.
• Notify supervisor or Director of any discrepancies or problems with any AR processes or payer issues.
• Ensure overpayments/refunds are appropriately processed and applied to patient accounts in a timely manner.
• Post Nextgen batches daily and follow up on any A/R issues in a timely manner.
• Maintain security and confidentiality of all patient account information.
• Perform work in compliance with company policy, department procedures and regulatory requirements, including HIPPA.
  
  

Secondary Functions

• Maintain file room in an orderly fashion.
• Process returned mail.
• Sort and file correspondence and perform miscellaneous clerical duties such as answering correspondence and writing reports.
• Cross train on other duties which may be necessary or desirable to serve the patient and support the success of the department or the company overall.
• Other duties which may be necessary or desirable to serve the patient and support the success of the department or the company overall.
  
  

Qualifications

Education and/or Experience; Certificates, Licenses, and Registrations (Minimum Requirements)

• High school diploma or equivalent.
• Minimum of two (2) years of relevant experience.
• An equivalent combination of education, experience and training that would provide the knowledge, skills and abilities required for the successful performance of the essential job duties.
  
  

Necessary Knowledge, Skills, And Abilities

• Knowledge of generally accepted office practices, procedures, and equipment.
• Ability to read and understand written and verbal communication.
• Computer literate with proficiency in Window's based programs.
• Ability to operate standard office equipment including copier, postage machine, printers, and 10-key by touch.
• Ability to work cooperatively and interact in a professional and respectful manner with physicians, staff, vendors, and patients at all times.
• Ability to communicate clearly and concisely, both orally and in writing.
• Detail oriented.
• Ability to maintain the highest degree of confidentiality.
• Knowledge of medical billing procedures, including CPT and ICD10 coding with familiarity with HCPC coding.
  
  

Physical Demands / Work Environment

• Majority of work is performed in a general office environment. Exposure to low to moderate levels of noise in a well-lit, well-ventilated, and fast paced environment.
• Requires manual/finger dexterity as necessary to perform daily job duties.
• Occasionally required to reach with hands and arms; lift, push, pull and/or carry objects up to 35 pounds.
• Frequently required to sit for extended periods of time.
• Frequent and/or continuous talking.
  
  

Reasonable Accommodations

To perform this job successfully, an individual must be able to perform each essential function satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EHN believes that each employee makes a significant contribution to our overall success. That contribution should not be limited by assigned responsibilities. This job description is designed to outline primary functions, qualifications and job scope, but is not intended to limit the employee or EHN to only those job functions identified. EHN expects each employee to offer his or her services wherever and whenever necessary to ensure superior customer service, quality patient care, and the success of our business.