Medical Billing & Account Receivable Specialist

POSITION SUMMARY: The AR/Collections Specialist position is responsible for assuring insurance claims are paid in a timely manner and performs collecting, reconciliation, research, correspondence, and independent problem solving. Additionally, this position may be required to travel to all office locations to meet business needs, as requested. ESSENTIAL JOB DUTIES: Responsible for collecting on accounts per department protocols. Processes claim appeals per departmental protocols. Reviews claim status daily to assure claim follow-up with payers. Analyze and research unpaid claims. Reprocess and submit accurate claims to payers. Reconcile accounts to determine underpayment, overpayment, or contractual adjustment correction. Manage aging reports. Batch and submit daily claims. Reach out to insurance companies regarding any discrepancy on unpaid/denied/rejected claims. Utilizes technical ability and understanding of applicable insurance contracts and regulations. Identifies and communicates any trends and carrier issues relating to billing and reimbursements. Prepares paper claims (CMS-1500) and electronic claim submissions for secondary filing. Processes inbound/outbound calls from insurance and patients with billing questions. Research and communicate any billing changes to achieve optimum performance. Update or add insurance carriers to the system. Respond to emails, flags, and overhead pages for billing related questions. Maintains patient confidentiality by following HIPAA policies and procedures. Other duties as assigned per the need of the organization and within scope of position. Position Requirements KNOWLEDGE, SKILLS AND ABILITIES: Knowledge of Microsoft Office products. Knowledge of Medical Billing, CPT and ICD-9/ICD-10, and HCPCS codes. Knowledge insurance carrier contracts. Knowledge of HIPAA regulations. Knowledge of medical terminology. Ability to work in a fast-paced environment and work well under pressure. Ability to work with currency and make change. Skill in working with an EMR system. Skill in communicating with insurance carriers as well as patients to get claims paid and collect any account balances. Ability to maintain confidentiality and maintain professionalism. EDUCATION AND/OR EXPERIENCE: Two to three years of medical insurance billing and collections experience. Proficiency in researching data for analysis and closure in the account receivable arena. Excellent customer service skills. Excellent verbal and written communication skills. Excellent analytical and problem-solving skills. Must possess a strong attention to detail. PHYSICAL DEMANDS/WORK ENVIRONMENT: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the following physical/work environment functions apply: Sit for extend periods of time, stand, talk, bend or hear. Type, utilizing a computer keyboard and mouse. May lift up to 25 lbs. Utilize a multi-line telephone system. #J-18808-Ljbffr