ADMIN - A/R ASSOCIATE

About the role

The Accounts Receivable Associate manages and processes billing and collections for Medicaid, private insurance, other third-party payers, and self-pay accounts. This role involves maintaining client demographic data, verifying benefits, and reconciling receivables with a focus on accuracy and efficiency. The position requires learning aspects of medical billing, claims and remittance processing, and associated software applications.

Responsibilities

• Generate and submit claims and invoices to insurers, third-party payers, and clients, ensuring accuracy and completeness of submissions.
• Verify and maintain data related to client demographics, insurance coverage, benefits, and authorizations.
• Maintain up-to-date information on payers’ billing requirements and covered services.
• Research and resolve claim denials and other issues impeding reimbursement for billed services.
• Resolve post-payment inquiries, audits, refunds, and recoupment requests as needed.
• Maintain effective communications within the Agency, clients, third-party payers, and other external organizations to ensure billing is accurate, timely, and well-documented.
• Report resolved and unresolved charges, status and expected turnaround times for outstanding issues, and projected incomes and adjustments.
• Collect and retain documentation related to A/R activities as appropriate.
• Prioritize responsibilities and work with minimal to moderate supervision, in electronic and paper formats.
• Maintain patient confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
• Comply with all agency policies.
• Assist the A/R Coordinator and Business Office management with special projects.
• Perform other duties as required.

Requirements

• A high school diploma and some experience with accounts receivable and/or benefits verification in a medical or developmental services setting preferred.
• 1 year of experience in Accounts Receivable.

Skills

• Proficiency with or ability to quickly learn software applications including Microsoft Office Suite, electronic health record and billing systems, and database systems.
• Understanding of or ability to learn the basics of the revenue cycle, from generation and recording of revenues to collections and cash projections.
• Understanding of or ability to learn medical billing and claims including but not limited to CPT, HCPCS, ICD-10, CMS-1500, and EDI transmissions.
• High attention to detail and an analytical mindset.
• Ability to perform assigned routine functions with a high degree of accuracy and with minimal supervision.
• Familiarity with government benefits programs (Medicaid/Medicare, Social Security, etc.) preferred.
• Ability to work independently and as part of a team.

This position requires working on site in the finance office.