Medical Accounts Receivable Specialist

Statement of Purpose This position is accountable for all steps in the billing process including processing medical claim information through data-entry in the EMR, and researching and correcting data entry errors using eClinicalWorks. This position uses knowledge of CPT and ICD-10 codes to determine the appropriate order and combination of alpha, numeric or symbolic data to ensure accuracy in entering medical claim information. This position is in a primary care and behavioral health social service setting. Sign on Bonus of $800 after 90 days of successful employment. Primary Tasks/Responsibilities Process an average of 80 claims daily including follow up accounts. Review claims data to ensure the insurance sequence is correct for billing (primary, secondary, etc.). Submitting claims for services rendered to insurance companies in a timely fashion. Verifying patients’ insurance coverage. Working directly with the insurance company, the patient, and clinic staff to get claims processed and paid. Ensuring patient demographics including name, date of birth, and insurance number are accurate on claims. Work closely with Third Party Liability (TPL), help patients update COBs. Know and understand CMS regulations for billing. Reviewing and appealing denied and unpaid claims to resolve denial instances. Achieve maximum reimbursement for services rendered. Monitoring and updating patient AR balances. Scrubbing of claims, timely follow-up for missing required items. Tracking and updating the Aging Report, and working patient accounts for accuracy. Answering questions patients, providers and third party insurers may have about billing. Reviewing patient bills for accuracy and completeness and obtaining any missing information. Handling collections and unpaid accounts by establishing payment arrangements with patients, monitoring payments, and following up with patients if or when there is a lapse in payment. Monitor and report billing error patterns. Cover Front Office locations as needed based on coverage needs. Sign in answer phone queues and emails for billing. Assist patients with the Sliding Fee Discount Program. Perform other duties as assigned. Education/Professional Minimum of 2 years of experience as medical biller or denial specialist in a primary care and behavioral health setting highly preferred. Experience working with multiple third party payers including Medicaid, Medicare, Managed Care, HMO/PPOs. Knowledge, Skills And Competencies Required Strong knowledge of and ability to easily navigate Medicaid, Medicare, HMOs, and private payer systems. Knowledge of EMR systems, preferably with eClinicalWorks. Microsoft suite and data systems proficiency, including Electronic Medical Records. Ability to effectively communicate both written and verbally. Ability to effectively utilize problem‑solving and decision‑making techniques. Ability to make effective judgments and decisions based on objective criteria. Demonstrated ability to work effectively and professionally with individuals from varied backgrounds and experiences. Attentive to detail and strong organizational skills. High comfort working in a busy environment with changing priorities. #J-18808-Ljbffr