What are the responsibilities and job description for the Accounts Receivable Specialist position at WES Health System?
The Accounts Receivable Specialist position performs various fiscal duties. This individual will assist the Accounts Receivable Manager to ensure that the AIR Department runs efficiently. The Specialist represents and supports the fiscal policy and procedures of the office, assisting with interpretation and follow up.
Works with minimal instruction or supervision.
MAJOR AREAS OF RESPONSIBILITIES:Billing
• Responsible for checking Unbilled Report for claims that can be coIlected prior to billing.
• Maintains contact with Business Account Specialist regarding Encounter EITor Log coIections.
• Prepares and processes all billing of services accurately and efficiently, on assigned billing dates.
• Checks billed files against Invoice Summary in Credible software. Note any differences on Billing Cover Sheet.
• Updates Billing Analysis spreadsheet on a weekly basis.
• Compares CBH's accepted files report against the Billing Analysis spreadsheet to ensure all files were adjudicated.
• Separates CBH rejections per programs and enters them into the Credible system within 1 week of receipt.
• Enters all rejections received from other payors (i.e. MA, Medicare, BHSI, Magellan, etc.) into Credible.
• Prints Denial Summary report for each program and attach to CBH or other payer's rejection sheets.
Collections• Responsible for collection efforts for all payers.
• Keeps track of corrections and resubmissions of rejections using Collection Efforts Worksheet.
• Prepares all 3rd party billing claims to submit new claims and rejected claims from CBH.
Filing• Filing system includes, billing files created weekly for CBH, MA, Medicare, BHSI, & Magellan. All documentation must be detailed and organized.
• Correspondence file for all payors.
• Separate files kept for all reports in dated order per week.
Policies & Procedures• Assist with the development of Accounts Receivable Policies and Procedures. Identify process enhancements and efficiencies.
• Adheres to duties and responsibilities as outlined in the Fiscal Policies and Procedures Manual.
Day-to-Day Operations• Maintains accurate records and supporting materials for all Accounts Receivable billing for audit purposes.
• Must be able to meet all deadlines that are imposed by the accounts receivable
processing procedures.
• Adherence to deadlines that are set by the Accounts Receivable Manager.
• Timely alerts to Financial Management of problems or concerns affecting assignments.
• Weekly status report - due Monday by 12:00 pm.
• Performs other related duties and tasks as assigned by the Accounts Receivable Manager.
QUALIFICATIONS:• High school graduate, courses in bookkeeping and/or business practices.
• Minimum of two (2) years experience in record processing, preferably in Accounts Receivable.
• Data entry experience, in a Health or Business office setting, preferably with knowledge of billing processing.
• Collection experience
- Health Care Plan (Medical, Dental & Vision)
- Retirement Plan (401k, IRA)
- Life Insurance (Basic, Voluntary & AD&D)
- Paid Time Off (Vacation, Sick & Public Holidays)
- Family Leave (Maternity, Paternity)
- Short Term & Long Term Disability
