AR Specialist / Healthcare Billing / Pharmacy

Responsibilities

• Ensure daily accomplishments work towards company goals for cash collections and Account Receivable over 90 days.
• Understand and adhere to state and federal regulations and company policies regarding compliance, integrity, patient privacy and ethical billing and collection practices.
• Research outstanding balances and take necessary collection action to resolve in a timely manner; recommend necessary demographic changes to patient accounts to ensure future collections.
• Research assigned correspondence; take necessary action to resolve requested information in a timely manner; establish appropriate follow up.
• Resubmit accurate and timely claims in formats including, but not limited to, CMS-1500 and electronic 837.
• Utilize the most efficient resources to secure timely payment of open claims or invoices, giving priority to electronic solutions.
• Negotiate payment plans with patients in accordance with company collection policies.
• Identify patterns of short-payment or non-payment and bring them to the attention of appropriate supervisory personnel.
• Review insurance remittance advices for accuracy. Identify billing errors, short-payments, overpayments and unpaid claims and resolve accordingly, communicating any needed system changes.
• Review residual account balances after payments are applied and generate necessary adjustments (within eligible guidelines), overpayment notifications, refund requests and secondary billing.
• Interact with third party collection agencies.
• Communicate consistently and professionally with other Amerita employees.
• Work within specified deadlines and stressful situations.
• Work overtime when necessary to meet department goals and objectives.

Qualifications

• A High School Diploma/GED or equivalent required; college degree preferred.
• A minimum of one (2) year of experience in medical collections with a working knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement; home infusion experience a plus.
• Working knowledge of automated billing systems.
• Working knowledge and application of metric measurements, basic accounting practices, ICD-9, CPT and HCPCS coding.
• Solid Microsoft Office skills required, including Word, Excel and Outlook.
• Ability to type 40 wpm and proficiency with 10-key calculator.
• Ability to independently obtain and interpret information.