Billing & Accounts Receivable Specialist

Billing & Accounts Receivable Specialist

The Billing & Accounts Receivable Specialist is responsible for the accurate and timely execution of all billing functions, including electronic and paper claim submission, patient eligibility verification, payment collection, accounts receivable follow-up, and authorization tracking. This role works closely with Registrars and internal departments to ensure compliance with financial policies, payer requirements, and overall revenue cycle efficiency.

Duties and Responsibilities:

• Submit all electronic claims within established timeframes.
• Complete and process all paper claims accurately and timely.
• Verify and document patient insurance eligibility and benefits prior to billing.
• Identify patient financial responsibility and ensure accurate billing of copays, deductibles, and coinsurance.
• Collect patient payments, including point-of-service collections when applicable.
• Monitor and follow up on assigned accounts receivable, including both insurance and patient balances, to ensure timely resolution.
• Conduct follow-up on outstanding patient AR, including statement review, payment arrangements, and escalation as needed.
• Monitor assigned accounts to ensure compliance with financial policies and timely reimbursement.
• Collect required data and prepare reports for external funding sources.
• Collaborate with Registrars to ensure accurate patient demographics, insurance information, and compliance with financial policies.
• Track and analyze payer trends; communicate findings to the CBO Manager.
• Evaluate billing processes for efficiency and recommend improvements.
• Communicate with private insurance companies to resolve billing issues and disputes.
• Respond to patient billing inquiries in a professional and timely manner.
• Complete daily Avatar Central Billing reports.
• Accurately post payments and denials in Avatar according to contracted rates.
• Maintain a minimum productivity standard of 100 hospital charges entered per day.
• Ensure all PIP charges are entered on the same day they are received.
• Monitor Avatar reports to confirm billing slips are received within 5 days of patient discharge and follow up with the CBO Manager as needed.

Minimal Qualifications:

Education: High School Diploma or equivalent.

Experience: One (1) year in clerical positions such as receptionists, data entry specialists, administrative assistants, file clerks, and front desk agents. Healthcare experience preferred but not required.

Training: Training in relevant computer programs Avatar, Smart, Cerner

Equipment Use: Computer, copier, facsimile, and shredder.

The above statement reflects the general details considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.