Accounts Receivable Associate (Hybrid)

Job Responsibilities

• Review insurance denials and take appropriate action.
• Check claims status via phone or portal.
• Submit Medical Records upon request and follow up on submission.
• Submit HCFA’s claims to insurance companies that do not accept electronic claims.
• Submit Retros authorization
• Work closely with insurance companies to resolve claims disputes.
• Identify and resolve billing errors and implement processes to prevent future issues.
• Identify and communicate process errors to optimize revenue cycle management.
• Utilize payor portals to gather claims status information.
• Respond promptly and professionally to inquiries from insurance companies, patients, and client’s representatives with good customer service.
• Ensure billing practices comply with HIPAA, CMS guidelines, and payor specific policies.
• Communicate with insurance companies daily.
• Must meet or exceed production and quality standards.

Required Qualifications

• A high school diploma or equivalent required.
• 1-2 years of experience in a related industry.
• Strong understanding of Explanation of Benefits (EOBs) to determine denial reasons and appropriate actions.
• Strong communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Attention to detail and strong organizational skills.
• Basic experience using computer software, including medical billing software.
• Proficient in Microsoft Office Suite, specifically Word, Excel, Outlook, and general working knowledge of Internet for business use.
• Strong problem-solving skills with attention to detail.
• Moderate knowledge of CPT, ICD-10.

Preferred Qualifications

• Associate’s degree in accounting, finance, healthcare administration, or a related field OR equivalent combination of education and experience.
• Must possess professionalism, superior organizational skills, communications skills that allow the ability to educate and influence, an unrelenting passion for persistent follow up, and a drive towards problem resolution.
• Drive for Results (Service, Quality, and Continuous Improvement) – Ensure procedures and processes are in place that will lead to delivery of quality results and continually reassess their effectiveness to achieve continuous improvement.
• Communication – Proficient verbal and written communication skills. Willingness to share and receive information and ideas from all levels of the organization to achieve the desired results.
• Teamwork – Commitment to the successful achievement of team and organizational goals through a desire to participate with and help other members of the team.
• Customer Service Focus – Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations.