Accounts Receivable Specialist

PRIMARY FUNCTIONS

• Manage all claims over 60-days on the A/R reports in a timely manner
• Work assigned denials and correspondence
• Utilize clearinghouse and insurance portals for claim status
• Report all trends detected in A/R management
• Prepare corrected claims and appeals, as needed
• Process inbound and outbound calls as needed to insurance carriers
• Follow all state and federal collections and HIPAA laws

REPORTS TO/SUPERVISES

• The Accounts Receivable Specialist reports directly to the Accounts Receivable Manager.
• This position works collaboratively with other Emergicon personnel in all departments.

ESSENTIAL DUTIES and RESPONSIBILITIES

• Manage all claims over 60-days on the A/R reports in a timely manner
• Work assigned denials and correspondence
• Utilize clearinghouse and insurance portals for claim status
• Report all trends detected in A/R management
• Prepare corrected claims and appeals, as needed
• Process inbound and outbound calls as needed to insurance carriers
• Follow all state and federal collections and HIPAA laws

REQUIRED KNOWLEDGE AND EXPERIENCE

• Maintain any certification applicable to job functions
• Computer Literacy
• Ability to communicate effectively and in a professional manner with patients, insurance carriers, co-workers, management, and others
• Detail Oriented
• Knowledge of managed care plans, insurance, medical terminology
• Knowledge of reimbursement fee schedules (Medicare and Medicaid)
• Knowledge of refund processes and requirements
• Ability to establish/maintain cooperative working relationships with staff
• Ability to prioritize and multi-task

PREFERRED KNOWLEDGE AND EXPERIENCE

• Experience in Medicare A/R, Commercial insurances, appeals, correspondence, and denials is a plus.