A/R Specialist

Role Description

The Accounts Receivable Specialist is a REMOTE POSITION and is responsible for the follow-up, collections, and recovery of problematic accounts due from health insurance payers. The normal schedule will be Monday - Friday from 8:00am until 4:30pm.

• Achieve performance appraisals with "meets expectations" or better
• Demonstrate independence and competence to work basic denials
• Demonstrate independence and competence in payer requirements for basic appeals
• Demonstrate independence and competence and ability in submitting correct claims for payers
• Demonstrate independence and competence in refund processing
• Demonstrate independence and competence and ability to teach how to check claim status via phone or website
• Demonstrate ability to complete on average 20 accounts per day
• Demonstrate ability to work accounts timely within 2 weeks of receiving denial or needing follow up
• Maintain audit percentage of 98%
• Follow NELC policies and procedures in the normal conduction of company business
• Assure that professional practice complies with state and federal regulations including HIPAA Privacy and Security regulations
• Ensure that confidentiality of patient information is maintained in accordance with state and HIPAA Privacy and Security regulations
• Effectively communicate both verbally & in writing inside and outside the organization
• Take the initiative to meet internal and external customer needs in a timely and courteous manner
• Establish and maintain good working relationships
• Display good judgment and take initiative
• Complete appropriate amount of work in a timely manner without jeopardizing quality

Qualifications

• A minimum of 3 years’ experience with third party health insurance claims office or plan administrator involved in processing health provider claims required
• A working knowledge of government health insurance plan benefits and the rules & regulations for obtaining reimbursement required
• Experience with healthcare patient accounting/billing/collections computer applications including electronic claims processing preferred
• Working knowledge of Home Infusion Therapy billing & collection preferred
• Practical experience with Medicare; Medicaid; and third-party payer contracts

Requirements

• Associates Degree or bachelor’s degree in Business Administration preferred
• Knowledge of HIPAA Privacy and Security requirements
• Working knowledge of federal/state fraud and abuse laws required

Benefits

• Remote / Hybrid Position
• Career Ladders
• Health Insurance
• Dental insurance
• Vision insurance
• Generous employer-matched 403b savings program
• Company paid: Life insurance, Short- and long-term disability insurance
• Paid time off
• And much more!