Accounts Receivable Specialist

Division:Eskenazi Health Sub-Division: Hospital Req ID: 26106 Schedule: Full Time Shift: Days Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus including at a network of Eskenazi Health Center sites located throughout Indianapolis. FLSA StatusNon-ExemptJob Role Summary The Accounts Receivable Specialist is responsible for maintaining the life of a claim which includes the following: Claims Submission and Processing, Charge Entry, Claim Edit, DNB, Stop Bills, Claim Rejection, Denial Management, Accounts Receivable Follow-up, No Response, Compliance and Billing Regulations, Variance, Correspondence and Credit Balance Resolution. The Accounts Receivable Specialist communicates with the insurance carriers to ensure appropriate and compliant payment of services via telephone, email, fax, payor website. This position reviews reports to determine trends and discusses with management to help resolve front-end errors, reviews and follows up on all claims not paid by carriers in a timely manner and claims not paid appropriately.Essential Functions and ResponsibilitiesProactively contributes to Eskenazi Health’s mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County. Models Eskenazi Health values of Professionalism, Respect, Innovation, Development and Excellence.Assist customer service with follows up on patient calls within a timely manner Maintains department weekly production and monthly quality measuresCommunicates effectively and appropriately with internal and external customers Acts independently seeking guidance when necessary to remain compliant with federal, state, and hospital policies relative to insurance patient billing.Initiates proper course of action for problem solving resolution Analyzes all claim denials to determine the best course of action to resolve any issue and receive appropriate paymentVerifies and updates claims with insurance and demographic information when changes are neededResolves inquiries from internal and external customersTakes active role in special projects as requestedGathers and distributes insurance information obtained through verbal and/or written communication for the purpose of maintaining sufficient cash flowAnalyzes and resolves issues reported from the self-pay outsource vendorUtilizes interpersonal communication strategies/skills to achieve desired outcome/results with patients/families and others Provides coverage for co-workers as necessary due to PTO/illness Continuing knowledge-based learning on payor guidelines and requirements for appropriate billingEnter daily charges for NTP clinicWorks charge review in a timely and accurate manner to ensure appropriate billing of servicesInvestigate and Resolves claim edits, rejections (internal/external), DNB, Stop Bills, follow up, variance, monitoring status of denials, denials, appeals, credit balance resolution and correspondence.Work queue management for better efficiency of work flows i.e. filters and rules. Follows up on unpaid claims with insurance companies.Initiate Billing/Charge Review resolutionJob RequirementsAssociate Degree in business-related field or technical training in coding and/or billing in lieu ofThree years of experience in medical practice/hospital setting with billing, insurance follow-up and/or credit balance experience.CPC Certification a plusDental, Vision, Behavioral Health and/or DME experience a plusKnowledge, Skills & AbilitiesPays close attention to detail with accuracy in record keeping and documentationIdentifies trends with denials (providers/locations/carriers) and works with management to help educate or resolve errors from the start and avoid back-end denialsWillingness and ability to assist other team membersExcellent problem-solving skills and ability to cooperate with othersWorks independently and efficientlyWorking knowledge of Microsoft Office Software, WindowsUtilizes calculator, printers, copiers, and fax machinesStrong math skillsStrong organizational skills and ability to work efficiently in a high volume, multi-task environment meeting deadlinesUses professional and appropriate communication skillsAdvanced understanding of health insurance medical policy and billing requirements, including government and managed care programs as well as traditional Medicaid, Medicare replacement plans, commercial carriers, HIP, AnthemAbility to meet production and accuracy requirements outlined by department goalsAccredited by The Joint Commission and named as one of Indiana’s best employers by Forbes magazine for two consecutive years and the top hospital in the state for community benefit by the Lown Institute, Eskenazi Health’s programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city’s primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the first verified adult burn center in Indiana and Sandra Eskenazi Mental Health Center, the first community mental health center in Indiana, just to name a few.