A/R Specialist

Job Description

A/R Specialist

McCurtain Memorial Hospital (hereinafter “MMH”) is an integrated healthcare system committed to delivering McCurtain County and southeastern Oklahoma with high quality, accessible healthcare – everything from emergent care in our 24-hour emergency room to surgical services. MMH is a 25-bed Critical Access Hospital (hereinafter “CAH”) equipped to offer a wide range of services to both in-patients and out-patients. Our skilled physicians, nurses, and other healthcare providers are here to provide quality, compassionate care.

This position description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications which may be required of the employee assigned to the position. Depending on the size of the facility the job duties may vary. Receipt of the job description does not imply nor create a promise of employment, nor an employment contract of any kind; my employment with the Company is at will.

McCurtain Memorial Hospital is seeking an experienced and detail-oriented A/R Specialist to join our revenue cycle team. The A/R Specialist is responsible for managing and overseeing the timely and accurate collection of payments for patient accounts, including insurance collections. This position will handle all aspects of the accounts receivable process, including working with insurance companies to resolve outstanding claims, handling patient account inquiries, and ensuring proper documentation is maintained. The A/R Specialist works closely with patients, insurance providers, the billing department, and other hospital staff to resolve discrepancies and outstanding balances. The ideal candidate will have a strong understanding of hospital financial processes, insurance collections, and excellent communication skills to manage complex accounts and ensure the hospital’s revenue cycle is efficient and accurate.

• Monitor and follow up on outstanding patient accounts, ensuring timely resolution of denied or delayed claims for services rendered.
• Review insurance claims for accuracy, resolve issues or discrepancies, and follow up with payers on unpaid or underpaid claims.
• Contact insurance companies via phone or online portals to inquire about the status of outstanding claims and to appeal denials.
• Maintain accurate and up-to-date records of all follow-up activities, communications, and resolutions for tracking and reporting purposes.
• Work closely with internal departments (billing, coding, patient services) and external insurance companies to facilitate the resolution of complex claims and billing issues.
• Generate AR reports and provide updates on the status of open claims, identifying trends and potential areas of concern.
• Ensure compliance with all federal and state regulations, payer-specific guidelines, and hospital policies related to billing and reimbursement for CAH services.
• Address patient billing inquiries and assist with resolving any discrepancies or concerns regarding their account balances.
• Identify opportunities to improve the AR follow-up process, and contribute to workflow optimization initiatives.

• High School Diploma or equivalent required; Associate's or Bachelor’s degree in healthcare administration, business, or related field preferred.
• Minimum of 2 years of experience, preferred, in Accounts Receivable follow-up, billing, or collections.
• Familiarity with insurance verification, claims processing, and payer systems.
• Understanding of ICD-10, CPT, and HCPCS coding, as well as insurance terminology.
• Strong attention to detail and accuracy in data entry and follow-up.
• Excellent communication skills, both written and verbal.
• Ability to effectively negotiate and resolve payer issues.
• Experience with healthcare billing software and AR management systems.

• High school diploma or equivalent required; Associate’s or Bachelor’s degree in Business, Finance, Healthcare Administration, or related field preferred.
• Basic computer skills and data entry skills required.
• Previous experience in patient collections within a hospital or healthcare environment and working with financial assistance programs and payment plans is highly preferred.
• Strong understanding of healthcare billing practices and patient financial responsibility.
• Familiarity with medical terminology, hospital charges, and healthcare billing systems
• Strong communication and negotiation skills with the ability to handle difficult situations in a professional and empathetic manner.
• Detail-oriented with strong organizational and time management skills.
• Knowledge of HIPAA and healthcare privacy regulations.
• Strong problem-solving skills and ability to work independently to resolve patient account issues.

McCurtain Memorial Hospital is an equal opportunity employer. By your signature below, you acknowledge receipt and understanding of the job description above, and you understand that while the hospital makes every attempt to fully and adequately define this job role, it is not possible to fully detail the day-to-day flexibility and ever-changing tasks that come with this role. You further acknowledge and understand that acceptance of this job description does not constitute a contract between you and McCurtain Memorial Hospital, and that MMH is an at-will employer headquartered in the State of Oklahoma.