Accounts Receivable Specialist

Position Summary

• The Accounts Receivable Specialist role and responsibilities include : monitoring all aspects of the

collection of outstanding debts owed to the health system including following up directly with

commercial and governmental payers to resolve claim issues and secure appropriate and timely

reimbursement, resolve missing and unresolved payment issues, and monitor overdue accounts,

Identify and analyze denials and payment variances and takes action to resolve

accounts including drafting and submitting technical appeals. In addition, the AR specialist is the

subject matter expert for all billing staff regarding insurance payer billing procedures.

Primary Position Responsibilities

required software programs. Utilizes all software systems in accordance with Patient Account

protocols, and addresses account write-offs in accordance with Hunterdon’s Account Adjustment

Policy and Procedures.

contractual requirements including CMS guidelines, Medicaid Guidelines, and Hunterdon’s

private payer contracts.

and annual tasks to resolve all accounts within defined payor guidelines and meeting or

exceeding productivity and quality standards and goals as defined by the Business Office

Management Team.

with payers to ensure timely resolution of all outstanding claims via phone, emails, fax, or payer

portals. Responsible for identifying and correcting medical billing errors, initiating required follow-

up actions, and submitting or resubmitting claims to third-party insurance carriers and

governmental payers in accordance with filing guidelines.

when claims are erroneously denied through investigating root cause of denial, compiling of data

to support the overturning of a denial, and creating the appeal documents, as well as following

through on communication with third-party payer to complete the recovery of denied funds.

explanation of patient responsibility is necessary.

preventable root cause issues and payer denials. Responsible for communicating identified

trends and issues to Business Office leadership and will perform special projects as needed.

Qualifications

Required :

High School Diploma or Equivalent

Associate’s Degree in Business Administration

Minimum Years of Experience (Amount, Type and Variation) :

Required :

Physician / Professional Billing Experience : 3 years required experience in

insurance payer contracts, submitting appeals, and a complete understanding of

insurance payer’s explanation of benefits and payer reimbursement rules.

2 years accounts receivable follow-up experience

License, Registry or Certification :

Required :

none

none

Knowledge, Skills and / or Abilities :

Required :

Must have strong organizational, problem solving and critical thinking skills

none

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