Accounts Receivable Resolution Specialist

MaineGeneral Health•Waterville, ME

9d•Onsite

About The Position

MaineGeneral Health is a comprehensive non-profit system with the mission of enhancing, every day, the health of our patients, our families and our communities. Join Our Team as an Accounts Receivable Resolution Specialist. This role presents an exciting opportunity to become an integral part of our dynamic team of professionals. You'll harness your problem-solving, analytical, and attention-to-detail skills to ensure payments are reimbursed promptly and accurately.

Requirements

A minimum of 2 years of work experience in Healthcare Insurance Follow-Up, Medical Billing, or a related field is required.
Familiarity with medical billing processes, including claim submission, coding, and insurance verification, is essential.
Strong attention to detail is crucial for accurately reviewing and editing claims, ensuring compliance with payer guidelines and regulations.
Ability to identify issues with claims and payment discrepancies and take proactive measures to resolve them effectively.
Excellent communication skills are essential for effectively liaising with patients, insurance carriers, and internal teams to ensure seamless billing processes.

Responsibilities

Prepare bills in both paper and electronic formats as per departmental and payer guidelines.
Review and edit claims for accuracy before submission to payers, ensuring the correct diagnosis and procedure codes are used.
Review and address claim rejections, denials, and appeals, taking necessary actions to rectify issues.
Prepare secondary and tertiary claims when required.
Determine and verify insurance coverage and coordination of benefits to facilitate timely billing.
Obtain retro-authorizations as necessary and allowed by policies.
Prepare and review routine billing reports, audits, and worklists.
Collaborate with multidisciplinary teams as needed to ensure billing accuracy, re-billing, and charge corrections.
Communicate with patients as needed to obtain accurate insurance coverage and coordinate benefits.