Accounts Receivable Specialist III

Description

 
About Our Company

Advanced Diabetes Supply® was founded on the bold principle of creating a knowledgeable, reliable and demonstrably superior diabetes supply company. Our approach, coupled with a commitment to service and innovation, has catapulted Advanced Diabetes Supply® to a national leader in the industry. Creating high-performance, adaptive teams requires a relentless commitment to hiring the best. We strive to maintain a casual, fun environment whenever possible, but we don’t just play around. We work hard every day to provide a positive work culture and respectful atmosphere. The standards we set for ourselves are high, and we love to be challenged! If you enjoy working in a collaborative environment, have a passion for excellence and a bias for action, we may be just what you’ve been looking for.

Interested in learning more about our company and its culture? Visit us at www.northcoastmed.com 

About The Position

Hours:  8:00 AM to 4:30 PM ET, Monday to Friday

Location: Hybrid (2-3 days) in our Doral, FL office.

The Accounts Receivable Specialist III is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as dictated below with guidance and support from AR & Billing leadership teams.

Essential Functions 

• Processes claims: investigates insurance claims; and properly resolves by follow-up & disposition.
• Verifies patient eligibility with secondary insurance company when necessary.
• Bills supplemental insurances including all Medicaid states on paper and online.
• Acts as a subject matter expert in claims processing.
• Manages billing queue as assigned in the appropriate system. 
• Manages and resolves complex insurance claims, including appeals and denials, to ensure timely and accurate reimbursement.
• Processes denials & rejections for re-submission (billing) in accordance with company policy, regulations, or third-party policy.
• Investigates and updates the system with all information received from secondary insurance companies.
• Ensures that all information given by representatives is accurate by cross referencing with the patient's account, followed by using honest judgement in any changes that may need to be made.
• Updates patient files for insurance information, Medicare status, and other changes as necessary or required.
• Keeps email inbox requests up to date; checks for new messages on an hourly basis.
• Assists management and team lead with motivating and coaching employees to succeed as needed. 
• Maintains accurate and detailed notes in the company system.
• Adapts quickly to frequent process changes and improvements.
• Is reliable, engaged, and provides feedback as to improve processes and policies.
• Attends all department, team, and weekly company meetings as required.
• Appropriately routes incoming calls when necessary.
• Meets company quality standards.
• Embraces and exemplifies ADS core values:

                o We put our people first.                 

                o We serve our members with passion                 

                o We take ownership                 

                o We pursue excellence                 

                o We never stop growing

Other Responsibilities 

• May perform any additional responsibilities or special projects as required.
• Duties and responsibilities may be subject to change based upon the needs of the department.
• May provide cross-functional support as business needs demand.

Requirements

• High School diploma or equivalent
• 2 years’ experience with insurance billing and processing claims
• 2 years’ experience with Medicare claims, and Medicare and private insurance verification
• Knowledge of insurance portals; familiarity with a variety of medical and/or insurance terms or practices
• Full knowledge all areas of collections specialization
• Proficiency in basic math and business calculations
• Working knowledge of computer/data entry with the ability to learn new systems
• Basic level of MS Office proficiency

Expected Competencies 

• Friendly, professional, and effective communications skills; able to calmly present solutions in challenging situations.
• Proactive identification of challenges, and solution-oriented approach to problem solving.
• Service-orientation and aptitude to aptitude to resolve insurance and/or patient matters.
• Effective analytical skills: able to use inductive and deductive reasoning to anticipate outcomes.
• Self-directed accountability and reliability
• Effective communication, and interpersonal skills, with the ability to influence and collaborate effectively with cross-functional teams.
• Cross-trained on all collections processes
• Able to resolve highly escalated collections issues or concerns
• Able to mentor and train as needed
• Able to manage and prioritize multiple tasks/projects, work autonomously, and meet deadlines.
• Able to work well in a team environment that promotes inclusiveness and communication among team members.
• Communication using both verbal and written English proficiency.
• Cultural competence

Physical Demands 

The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable employees with disabilities to perform the essential functions.

While performing the responsibilities of the job, the employee is required to remain in a stationary position most of the time (stand or sit). While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is frequently required to stand, walk and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

Other Requirements

• Candidates must successfully pass a background check.
• Candidates must be able to provide proof of eligibility to work in the United States without sponsorship.

Pay Range and Compensation Package 

Pay ranges may vary depending on location. Actual compensation depends on education, experience, and relevant skills. 

Benefits for full-time employees include:

• Health, Dental & Vision options
• FSA and HSA plan with Employer Contribution
• Employer paid EAP
• 401k with 4% Company Match
• Paid Time Off (PTO) Including 7 Paid Holidays and a Birthday Holiday
• On-Site Gym
• In-house Training Programs
• A fun culture in a fast-growing organization!

Equal Opportunity Statement 

Advanced Diabetes Supply® provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type based on 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.   

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