Accounts Receivable Specialist

Responsibilities

• Complete accounts receivable collections and follow-ups to expedite insurance payments for assigned claims.
• Contact insurance companies via phone, mail, or clearinghouse correspondence to address account inquiries and update information.
• Communicate claim issues related to patient benefits to the verification team and field staff for resolution.
• Proactively collaborate with third-party payers to resolve claims processing issues, improve communication, and stay updated on changes to plan requirements.
• Aid in streamlining policies and procedures for more effective and efficient operations of third-party carriers, providing updates to the Billing Supervisor as needed.
• Prepare and assist with monthly reports, focusing on key indicators, payer issues, and unit performance, with a goal to improve metrics such as DSO (Days Sales Outstanding).
• Process appeals by gathering required documentation, resubmitting claims, and following up promptly to track resolution.
• Maintain compliance with HIPAA and CMS guidelines in all interactions and documentation.

Qualifications

• Education: Bachelor’s degree or Associate’s degree with 3 years of professional office experience, or High School diploma/GED with 5 years of experience (healthcare setting preferred).
• Strong attention to detail and a thorough, results-oriented work ethic.
• Self-motivated, with a professional curiosity to learn and recommend innovative solutions.
• Excellent communication and interpersonal skills.
• Ability to adapt in a fast-paced environment, remain calm under pressure, and multitask effectively.
• Commitment to providing exceptional customer service, maintaining professionalism, and supporting team collaboration.
• Knowledge of insurance benefit coordination, medical billing, and credentialing.
• Ability to use independent judgment to handle confidential information responsibly.
• Experience analyzing and interpreting data to prepare actionable reports.
• Computer Skills: Proficiency in Microsoft Office applications (Outlook, Excel, Word, and Publisher). Experience with Internet browsers, including Chrome, Edge, and Firefox. Familiarity with EMR systems, clearinghouses, and medical billing software.