Medical Accounts Receivable Specialist

100% remote role, will supply equipment, must have Physician Billing A/R experience

Duties and Responsibilities

• Assist team members by answering questions and providing support for their ongoing success
• Provide initial training on the client host system
• Assist in tracking productivity and quality of Accounts Receivable Representatives
• Identify areas of opportunity for improvement through one on one evaluation of Accounts Receivable team
• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
• Meets and maintains daily productivity/quality standards established in departmental policies and supports training needs identified to ensure teams success in this area
• Meets and maintains quality standards established in departmental policies and supports training needs identified to ensure the teams success in this area
• Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts
• Adheres to the policies and procedures established for the client/team 
• Knowledge of timely filing deadlines for each designated payer
• Initiate appeals when necessary 
• Identify and correct medical billing errors
• Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process
• Ability to analyze, identify and resolve issues causing payer payment delays 
• Ability to analyze, identify and trend claims issues to proactively reduce denials
• Understanding of under payments and credit balance process
• Perform special projects and other duties as needed
• Act cooperatively and courteously with patients, visitors, co-workers, management and clients
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) 

Qualifications

• High School diploma or equivalent required
• Experience in insurance collections, including submitting and following up on claims for a Medical Practice, Medical Facility/Medical Billing Company, Ambulatory Surgical Center, and/or Hospital 
• Experience with training new users
• Knowledge of the denied claims and appeals process
• Experience with practice management systems. EPIC PB, Allscripts and/or Cerner preferred 
• Extensive knowledge of individual payor websites, including Navinet and Novitasphere
• Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes 
• Ability to work well individually and in a team environment
• Proficiency with MS Office. Must have basic Excel skillset.
•  Strong communication skills/oral and written 
• Strong organizational skills 
• Work independently from assigned work queues
• Maintain confidentiality at all times 
• Maintain a professional attitude