Accounts Receivable Specialist

Job Summary:

The Accounts Receivable (AR) Specialist is responsible for calculating and preparing estimates for procedures, managing Out-of-Network approval requests, responding to attorney requests regarding lien agreements, and maintaining follow-up on all lien accounts receivable balances.

Key Responsibilities:

Essential Functions:

• Calculate and prepare accurate estimates to maximize up-front cash collections, including co-pays, deductibles, and co-insurance.
• Provide patients with personalized financial responsibility estimates based on their insurance coverage prior to service for both Hospital and Pain Center services.
• Review scheduled appointments and contact patients in advance to discuss financial responsibility and payment arrangements for past due or bad debt balances, in adherence to hospital Collection Policy.
• Prepare estimates for procedures upon attorney request.
• Provide billing and transaction documents to attorneys upon request.
• Maintain and follow up on Accounts Receivable aging for Lien account balances.
• Calculate expected payment for account resolution of Lien Agreements.
• Review and calculate requests for Out-of-Network approval for surgical procedures prior to service.
• Manage recurring debit/credit card payments, including denied transactions and expired transactions for increased payment plans.
• Cross-train as needed to support other areas of the Patient Services Department and provide coverage for breaks, illness, vacations, or shifts.

Non-Essential Functions:

• Perform other duties as assigned.
• Actively support and uphold the mission and core values of the Hospital.
• Remain knowledgeable of and follow hospital policies.
• Maintain confidentiality of patient and hospital information at all times.
• Keep the Manager informed of relevant day-to-day situations.

Qualifications & Requirements:

• High School diploma or equivalent required.
• 3-5 years of accounts receivable experience within healthcare revenue cycle.
• Proficiency in MS Office Suite and other relevant computer applications.
• Strong organizational skills, attention to detail, and ability to multitask effectively.
• Experience in healthcare and/or insurance billing preferred.
• 1-2 years of experience in preparing estimates preferred.

Environmental and Physical Requirements:

• Must be able to read and speak English fluently.
• Cognitive skills required for math, reading, and computer-related tasks.
• Strong communication skills to interact effectively with the public and peers.
• Vision capabilities for near, mid-range, far, and accommodation.
• Hearing capabilities for low, medium, and high-pitched sounds.
• Minimal up-and-down activity may be required.
• Job risks include exposure to computer screens for 6-7 hours per day and typing activities.
• Ability to lift a maximum of 20-30 pounds.