Accounts Receivable Specialist II

Job Description: Facility AR Specialist (Levels I, II, III)

Position Overview

The Facility Accounts Receivable (AR) Specialist plays a vital role in ensuring accurate and efficient revenue cycle management within the organization. This position is responsible for verifying patient benefits, managing payments, tracking receivables, and facilitating seamless communication with billing and management teams. The role encompasses responsibilities ranging from entry-level tasks (Level I) to advanced duties requiring specialized expertise (Level III).

Key Responsibilities

• Patient Benefits and Eligibility
• Verify and document insurance benefits and eligibility for scheduled patients to ensure proper billing and reimbursement.
• Communicate any discrepancies or potential issues with the scheduling and clinical teams promptly.
• Submit ALL Facility claims via the EHR, MedNet.

Payment Management

• Upload patient copays accurately into the financial systems.
• Track payments for advanced surgical procedures, ensuring proper allocation and reconciliation.
• Follow up on incorrect payments or delays, coordinating with insurance companies or patients as needed.

AR Communication and Coordination

• Participate in bi-weekly AR calls with Golden Springs to review outstanding accounts, payments, and ongoing issues.
• Provide updates and action plans during meetings to ensure efficient AR resolution.
• AR Review and ensure all claims submitted have been paid out according to payor contracted rates.

Billing and Documentation Review

• Screen all billing prepared by the Billing Specialist (post-Ingrid preparation) to confirm the inclusion of all required supporting documents for processing.
• Ensure accurate and complete documentation before submission to payers.

Document Management

• Upload all billing records into MedNet and maintain organized files within the shared OneDrive system.
• Regularly review and update files to maintain compliance and accessibility for internal and external audits.

Qualifications

Education and Experience

• Level I: High school diploma or equivalent; 1-2 years of experience in AR, medical billing, or a related field.
• Level II: Associate degree or equivalent experience; 2-4 years in AR or medical billing, with increasing responsibility.
• Level III: Bachelor's degree or equivalent; 4+ years in AR, medical billing, or healthcare finance with demonstrated expertise in handling advanced cases.

Skills and Competencies

• Proficiency in insurance verification and payment tracking systems.
• Strong attention to detail and organizational skills.
• Effective communication and problem-solving abilities.
• Familiarity with billing software, MedNet, and OneDrive.
• Knowledge of medical terminology, coding, and reimbursement processes preferred.

Additional Information

• This role may require occasional travel for training or meetings.
• The ability to handle sensitive patient information with confidentiality and professionalism is essential.