Accounts Receivable Specialist RCM- Team Lead

Job Description

Job Description

Description:

Core Clinical Partners stands at the forefront of Emergency and Hospital Medicine, delivering unparalleled services through a model that emphasizes patient-centric care and operational excellence. Our corporate values – Genuine, Accountable, Dynamic, Respectful, and Fun – are the pillars that uphold our commitment to revolutionize healthcare delivery.

The Senior Accounts Receivable Specialist will utilize multiple EMR systems to review and satisfy billing edits, charge information, private or government insurance benefits, and other related information from multiple billing and documentation servers (for multiple hospitals, clinics and insurance companies)

Under the direction of the AR Manager, the Sr. AR Specialist will follow up on outstanding AR for all payers including self-pay and resolution of denials. This position is responsible for handling all correspondence related to an insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get maximum payment on accounts and identify issues or changes to achieve client profitability.

Essential Duties:

• Investigate, follow up with payers, and collect the insurance accounts receivable assigned by the manager of outsourced and internal AR aging, clearinghouse rejections, and payer denials.
• Perform comprehensive follow up activities that facilitate cash collections and document follow up activity in the appropriate system.
• Maintain professional interaction with colleagues and clients.
• Identify any payer-specific issues and communicates to team and manager.
• Comply with performance and productivity standards while maintaining quality levels, as set forth by senior leadership.
• Navigate and utilize payer websites for appeals/reconsiderations, medical records attachments, verification of benefits and/or web-based claims follow up.
• Research and completes special projects and requests as needed.
• Participates in staff meetings and assigned continuing education, and recommends new approaches, policies, and procedures to effect continual improvement in efficiency of the department and services performed.
• Maintains a strict level of confidentiality for all company, departmental, and healthcare provider information.
• Provide excellent customer service while addressing payment-related issues.
• Performs other related duties as assigned.

Skills, Knowledge, Abilities:

• Displays the ability to manage difficult or emotional customer situations; responds promptly to customer needs; solicits customer feedback to improve service; responds to requests for service and assistance; meets commitments.
• Has knowledge of commonly-used concepts, practices, and procedures within the field of Accounts Receivable; exhibits ability to learn and apply new skills; keeps abreast of current developments; requires supervision; displays understanding of how job relates to others; uses resources effectively.
• Displays willingness to make decisions; exhibits sound and accurate judgment; supports and explains reasoning for decisions; includes appropriate people in decision-making process.
• Prioritizes and plans work activities; uses time efficiently; sets goals and objectives; develops realistic action plans.
• Identifies and resolves routine problems in a timely manner; gathers and analyzes information skillfully; displays the ability to recommend alternate solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics.
• Communicates changes and progress on assigned project tasks; completes projects on time.
• Excellent analytical and problem-solving skills.
• Effective communication and interpersonal skills.
• Detail-oriented and capable of meeting tight deadline
• Ability to work within a team environment
• Exhibit growth mindset and team-orientated behaviors

Core Clinical Partners is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Education:

• High school diploma required.
• Bachelor’s degree in Accounting, Finance, or related field preferred

Experience:

• Proven experience in accounts receivable or related financial role.
• 5 years’ experience in Healthcare Revenue Cycle required.
• Proficient in using payer software and EMR systems.