Accounts Receivable Specialist

Accounts Receivable Specialist

Become a valued team member for a dynamic, growing, fast-paced oral surgery practice where you are encouraged to learn and grow! Our world-class team includes highly skilled oral and maxillofacial surgeons dedicated to providing outstanding care and service to all of our patients. We offer exceptional benefits, 401k (with match), eight paid holidays, and you accrue up to four weeks of vacation in your first year alone!

The Accounts Receivable Specialist plays a vital role in our organization as a liaison between Insurance Companies, Patients and our Practices. The Accounts Receivable Specialist supports the Flagship Practices by processing and resolving claims that have been submitted to Insurance Companies for services provided to our Patients. As a detailed-oriented professional, the Accounts Receivable Specialists monitors, documents resolution activities, and submits information necessary to generate Insurance Payments. This includes, but is not limited to, confirming the claims are received and on file for payment processing, sending medical records for proof of medical necessity, requesting payments, and submitting appeals to overturn denials.

Essential Duties & Responsibilities:

• Resolves claims submitted to Insurance Companies utilizing Insurance Company portals/websites as well as Insurance Company contact/call centers to capture the status on claims and collects payments for services provided.
• Researches denied claims to determine next steps in claim resolution.
• Drafts appeal letters and submits additional information needed for Insurance Companies to process claims for payment.
• Tracks and communicate payment and denial trends.
• Documents claim resolution activities in the practice management system, detailing the movement towards resolution.
• Ensures all claims reviewed/processed are in correct account category in the practice management system.
• Reports on status of assigned accounts to Revenue Cycle Supervisor weekly/upon request.
• Completes ad hoc claim work lists assigned by Revenue Cycle Leadership.
• Communicates effectively with co-workers, insurance companies, Practices, Providers, and Patients.
• Maintains and promotes professional competence through continuing education and other learning experiences.
• Adheres to HIPAA Privacy and Security policies and procedures while performing job duties and responsibilities.
• Actively participates in Revenue Cycle Team meetings, voicing successes, barriers, and process improvement opportunities.
• Performs other duties as assigned.

Minimum Qualifications:

• High school diploma/GED

Preferred Qualifications:

• Bachelor's degree in Accounting or related field
• 2-3 years Medical and/or Dental Office experience
• Knowledge of Medical/Dental Insurance

Carolinas Center for Oral & Facial Surgery