What are the responsibilities and job description for the Claims Receivable Specialist position at Private Label Staff?
Job Description
Job Description
Salary : Job Summary
The Senior Accounts Receivable Specialist plays a leadership role in managing complex insurance billing tasks, mentoring junior staff, and ensuring efficient revenue cycle operations. This advanced position focuses on enhancing departmental workflows, resolving escalated issues, and maintaining compliance with regulatory guidelines.
Key Responsibilities
- Oversee tasking of orders across internal systems such as Salesforce, Brightree, and Oracle.
- Manage and resolve complex claim denials, appeals, and billing discrepancies.
- Provide mentorship and guidance to junior team members on insurance processes and workflows.
- Analyze and report on departmental metrics, including daily, weekly, and monthly data.
- Coordinate with payers, patients, and healthcare providers to ensure timely claim resolutions and approvals.
- Monitor team production and quality to ensure KPIs are met or exceeded.
- Lead process improvement initiatives to enhance workflow efficiency and compliance.
- Reconcile accounts receivable balances and oversee reporting on AR trends.
- Maintain compliance with Medicare LCD requirements and payer-specific guidelines.
- Perform miscellaneous duties and support management in departmental projects.
Knowledge, Skills, and Abilities
Qualifications
