Our client is in the business of assisting healthcare providers and healthcare networks properly resolve billing issues and errors by becoming an extension of their clients' billing departments. They are more successful than similar companies because they care about people (patients) and do their best to assist patients navigate the complex web of patient care, health insurance, etc. The AR Specialist needed for the team will work with a particular client to help ensure claims are properly billed, paid, processed, etc. In addition to competitive pay, our client offers paid health insurance, 401K, promotion opportunities, professional development and training, state of the art technology/systems and resources, as well as generous PTO!
Review and process outstanding accounts receivable
Assist client in facilitating payment on claims for services rendered based on insurance company policies and processes.
Resolve claim errors; research claim issues; perform insurance verification
Provide continuous case management for 40 to 50 accounts daily
Prepare and submit electronic and paper claims for insurance carriers, including, but not limited to governmental and managed care payers
Review payments for accuracy including those from remittances and EOB’s
Process appropriate adjustments and/or payments when necessary
Investigate and reprocess denials and partial payments
Prepare patient files verifying completeness and accuracy of information such as: Patient/Guarantor data,
Insurance data, Authorizations (when necessary), Financial data (charges, payments, and adjustments), etc.
Follow all HIPAA related procedures ensuring the maintenance of patients’ PHI (Protected Health Information)
Carry out other related tasks as assigned
Minimum of 2 years experience in Hospital Patient Accounting or medical insurance environment
Proficiency in Microsoft Word and Excel and Outlook
Knowledge of CPT-4/HCPC, ICD-9-CM, ICD-10CM, DRGs and Revenue Codes
Knowledge of UB-04, and 1500 bill forms
Familiarity with third party billing practices,
Familiarity working with managed care and governmental payment providers
Possible travel to hospital site locations for escalated matters requiring face to face interaction