MEDICAL ACCOUNTS RECEIVABLE SPECIALIST

Responsibilities

• Manage denial inventory for all assigned payer plans.
• Managed aged claim inventory for all assigned payer plans.
• Responsible for keeping management informed of payer trends and issues resulting in delay of reimbursements.
• Timely submission and follow-up of appeals and grievances.
• Respond to patient and insurance inquiries in a timely manner and update accounts as necessary.
• Manage payer issue projects and bulk appeals.
• Identify, document, and perform claim adjustments.
• Manage insurance correspondence.
• Verify patient eligibility as necessary.
• Participates in on-going training for compliance, payer information, and insurance benefits to augment knowledge of procedures, regulations, and products.
• Comply with performance standards and departmental goals.
• Absorb overflow calls for PFS as needed.
• Maintain HIPAA compliance.
• Uphold all SMIL policies and procedures.
• Other duties as deemed necessary.

Requirements

• High School Education or General Education Degree (GED) required.
• Minimum 1 year of experience in medical accounts receivable preferred.