Accounts Receivable Collection Specialist - Healthcare

CenterWell Senior Primary Care•The Villages, FL

12d•Onsite

About The Position

As a Billing Specialist, you will be responsible for ensuring that patient information is accurate and up to date, follow up on unpaid claims, resolve any discrepancies, and appeal denied claims to ensure that the healthcare provider is compensated for their services. Billing Specialists often communicate with patients to verify insurance details, inform them about their billing statements, and address any questions or concerns while ensuring compliance with HIPAA guidelines and other regulations. This role ensures all outstanding accounts receivable claims are followed up in a timely manner and appropriate actions are taken to resolve accounts and maximize collections. The specialist will monitor and respond timely and accurately to calls or correspondence from insurance companies, submit pending and/or holding claims for designated insurance groups for all facilities within the appropriate time designated by the payer, and utilize the Athena Claim Worklist to prioritize and effectively work all denied claims, including held claims in Athena due to insurance rejections of claim status daily to ensure timely claims processing. The role also involves submitting claim Reconsiderations, Appeals and/or corrected claims as needed, reviewing assigned Athena cases and emails at least twice daily and responding to all within 24 hours with follow-up, and following up with 3rd party payers on claims not paid according to contract. Secondary and/or paper claims for assigned payers will be submitted as needed, and an End of Month Checklist will be completed within the designated time frame. Exceptional customer service will be provided to patients by responding to their inquiries in a timely and professional manner.

Requirements

High School graduate or equivalent
Proficient skill in computer programming and Microsoft products. Including Excel, Word, and Outlook

Nice To Haves

Two years of experience and working knowledge in medical billing functions of third-party payer systems including Medicare and commercial insurance.

Responsibilities

Ensures all outstanding accounts receivable claims are followed up in a timely manner and appropriate actions are taken to resolve accounts and maximize collections.
Monitor and respond timely and accurately to calls or correspondence from insurance companies.
Submit pending and/or holding claims for your designated insurance group for all facilities within the appropriate time designated by the payer.
Utilize your Athena Claim Worklist to prioritize and effectively work all denied claims, including held claims in Athena due to insurance rejections of claim status daily to ensure timely claims processing.
Submit claim Reconsiderations, Appeals and/or corrected claims as needed.
Review all your assigned Athena cases and emails at least twice daily and respond to all within 24 hours with follow-up.
Follow up with 3rd party payers on claims not paid according to contract.
Submit secondary and/or paper claims for assigned payers as needed.
Complete End of Month Checklist within the designated time frame.
Provide exceptional customer service to patients by responding to their inquiries in a timely and professional manner.