Full-Time Accounts Receivable Specialist

Accounts Receivable Specialist - Medical Claims

Remote U.S. (designated states)

This position is fully remote and may be performed from one of the following U.S. states: AL, AZ, FL, GA, IN, KS, MA, MI, MS, NC, NV, OR, PA, SC, TN, TX.

The Accounts Receivable Specialist ensures accurate, compliant, timely billing and appropriate reimbursement for multispecialty medical professional services from various insurance payers and patients. This includes: correct and timely collection of unpaid patient accounts with goals to be met, re-billing, payment posting, contractual write-offs, adjustments, appeals per multi-state and federal insurance regulations for patients receiving services with our clients.

1. Prepare and re-submit clean claims to various insurance companies either electronically or by paper in accordance with specific payer guidelines and/or contract requirements.
2. Analyze and correct first pass rejected claims for completeness and accuracy of information for second pass clean claim submission.
3. Research and perform all primary and secondary billing claim status follow up activities for assigned insurance plans.
4. Review, evaluate and process all claim appeals through resubmission to insurance carriers with complete and accurate supporting documentation required.
5. Research and recommend any customer account adjustments and/or write-offs to the Manager based upon collectability of account with insurance carrier or patient.
6. Recognize and report claims problems, errors, and discrepancies to management in order to proactively identify and effectively resolve billing trends in a timely manner.
7. Generate and submit monthly patient balance due statements to customers as dictated by the explanation of benefits received from their insurance carrier.
8. Reviewing patient accounts, identifying delinquent accounts, and collecting overdue payments.
9. Answering patient questions about billing and payments.
10. Investigating and/or directing patient inquiries or complaints to the appropriate staff member.

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