A/R SPECIALIST I

Job Description

Job Description

Description:

Position Summary :

The Accounts Receivable Specialist I is responsible for managing and processing billing, and collections for Medicaid, private insurance, other third-party payers, and self-pay accounts. The A/R Specialist I is also responsible for accurately applying payments, reconciling accounts, and ensuring timely payment posting. This role requires an understanding of medical billing, claims and remittance processing, and the associated software applications.

M-F in office position.

PAY: $23-$25/hr.

Essential Responsibilities :

· Generate and submit claims and invoices to insurers, third-party payers, and clients, ensuring accuracy and completeness of submissions.

· Verify and maintain data related to client demographics, insurance coverage, benefits, and authorizations. Maintain up-to-date information on payers’ billing requirements and covered services.

· Research and resolve claim denials and other issues impeding reimbursement for billed services. Resolve post-payment inquiries, audits, refunds, and recoupment requests as needed.

· Develop and monitor cash flow projections for all assigned areas of responsibility.

· Maintain effective communications within the Agency, clients, third-party payers, and other external organizations to ensure that billing is accurate, timely, and well-documented.

· Report resolved and unresolved charges, status and expected turnaround times for outstanding issues, and projected incomes and adjustments. Report on cash receipts and GL activities as appropriate.

· Collect and retain documentation related to A/R activities as appropriate.

· Prioritize responsibilities and work independently with minimal supervision, in electronic and paper formats.

· Maintain patient confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).

· Comply with all agency policies.

· Cash management: Receive cash/check/digital payments and maintain assets securely. Prepare cash receipts log and deposit listings. Make bank deposits as needed.

· Assist the Revenue Cycle Manager with special projects

· Perform other duties as required

Qualifications :

Education and Experience

• Associates Degree and 1 year experience with accounts receivable and/or benefits verification in a medical or developmental services setting preferred.
• High school diploma or GED
• 3 years of experience in Accounts Receivable with an emphasis on healthcare billing,
• Valid Driver's License
• Auto Insurance policy with minimum policy coverage - $100,000/$300,000

Skills and Abilities

• Proficiency with software applications including, but not limited to, Microsoft Office Suite and database systems. Experience with Excel is highly weighted.
• Proven understanding of accounting cycle of accounts receivable, from generation and recording of revenues to collections and cash projections.
• Understanding of medical billing and claims including but not limited to CPT, HCPCS, ICD-10, CMS-1500, and EDI transmissions.
• Experience with electronic medical records (EMR) and medical billing software.
• High attention to detail and an analytical mindset.
• Ability to perform assigned functions with a high degree of accuracy and with minimal supervision.
• Familiarity with government benefits programs (Medicaid/Medicare, Social Security, etc.) preferred.
• Ability to work independently, and as part of a team.
• This position requires working in the finance office.