Full-Time Accounts Receivable Specialist

Accounts Receivable Specialist The Role: The Accounts Receivable Specialist plays a crucial role in our revenue cycle management team, dedicated to ensuring the accurate, compliant, and timely billing and reimbursement of multi-specialty medical professional services from diverse insurance payers and patients. This pivotal position involves meticulous attention to detail in the collection of unpaid patient accounts, setting and achieving specific goals, proficiently managing re-billing, payment posting, contractual write-offs, adjustments, and appeals in accordance with multi-state and federal insurance regulations. The ideal candidate will demonstrate a strong commitment to maintaining revenue integrity while upholding the highest standards of professionalism and compliance.

Key Responsibilities:

• Prepare and accurately resubmit comprehensive corrected claims to various insurance companies, adhering closely to specific payer guidelines and contractual requirements, both electronically and via paper submission.
• Conduct thorough analysis of first pass rejected claims, ensuring completeness and accuracy of information for subsequent clean claim submission, thereby minimizing delays in reimbursement.
• Perform diligent research and follow-up on the status of primary and secondary billing claims for assigned insurance plans, proactively resolving any outstanding issues to expedite payment.
• Review, assess, and process all claim appeals, meticulously resubmitting to insurance carriers with comprehensive and accurate supporting documentation to maximize reimbursement.
• Evaluate customer accounts and recommend adjustments or write-offs to the Manager based on the collectability of accounts with insurance carriers or patients, maintaining a balanced approach to revenue recovery.
• Identify and promptly report any billing problems, errors, or discrepancies to management, facilitating proactive resolution of billing trends and ensuring ongoing revenue integrity.
• Generate and distribute monthly patient balance due statements in accordance with the explanation of benefits received from insurance carriers, fostering transparent communication, and facilitating timely resolution of outstanding balances.

Minimum Requirements:

• One to three (3) years of experience in medical insurance claims billing and collections preferred.
• Proficient in Google for Business, MS Office, Excel and Word.
• Experience with physical therapy EMR systems is a plus.
• A customer success-oriented attitude.
• Excellent communication and negotiation skills.
• Problem-solving aptitude.

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