What are the responsibilities and job description for the Insurance Accounts Receivable Specialist position at Retina Group of Florida?
The Retina Group of Florida is looking to hire an Insurance Accounts Receivable Specialist to join our revenue cycle team! The Insurance Accounts Receivable Specialist is responsible for managing and resolving outstanding medical claims and denied claims to ensure prompt and accurate payment. The Insurance Accounts Receivable Specialist involves insurance follow-up, appeals, and reconsiderations via online portals and phone communication to reduce accounts receivable balances effectively.
Key Responsibilities:
Claims Management:
Review and follow up on outstanding medical claims to ensure timely payment.
Identify and address denied claims by initiating appeals or reconsiderations.
Investigate and resolve discrepancies in payments and posting errors.
Revuew and validate insurande refunds request and overpayments.
Work on special AR projects assigned, ensuring deadlines are met and goals are achieved.
Insurance Follow-Up:
Communicate with insurance carriers through portals or phone to verify claim statuses, obtain necessary information, and resolve issues.
Track and document all follow-up actions and communications accurately in the system.
Appeals and Reconsiderations:
Prepare and submit appeals or reconsideration requests with supporting documentation.
Ensure appeals are submitted within the required timeframes and monitor their progress
Documentation and Reporting:
Maintain detailed and accurate records of claims, payment information, and actions taken.
Upload Explanation of Benefits (EOBs) and supporting documents into the system following established protocols.
Provide status updates and summaries of unresolved claims to the billing supervisor as needed
Process Improvement:
Identify trends in denials or payment issues and suggest process improvements to minimize future occurrences.
Stay updated on changes in insurance policies, regulations, and payer requirements.
REQUIRED SKILLS/ABILITIES:
Strong knowledge of medical billing, insurance claims, and coding (ICD-10, CPT, HCPCS).
Proficient in using insurance portals and electronic health record (EHR) systems.
Excellent communication skills
Knowledge of billing procedures and collection techniques
An excellent understanding of AR processes, third-party payers, and CMS regulations
The ability to read and understand EOBs
Ability to prioritize tasks properly
Excellent verbal and written communication skills
Knowledge of Nextech Practice and TriZetto is a plus
Ability to prioritize tasks properly
Ability to work both in a team environment and independently
Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and the ability to learn new systems quickly.
Problem-solving mindset with the ability to identify trends, analyze issues, and implement solutions
Job Type: Full-time
Benefits:
401(k)
401(k) matching
Dental insurance
Disability insurance
Flexible spending account
Health insurance
Life insurance
Paid time off
Vision insurance
Schedule:
8 hour shift
Overtime
Ability to Relocate:
Boynton Beach, FL 33472: Relocate before starting work (Required)
Work Location: Hybrid remote in Boynton Beach, FL 33472
