Accounts Receivable Specialist

HHC•Indianapolis, IN

About The Position

The Accounts Receivable Specialist maintains the full claim lifecycle, including claims submission and processing, charge entry and review, claim edits, DNB and stop bills, rejections, denial management, accounts receivable follow-up, compliance with billing regulations, variance review, correspondence, and credit balance resolution. The specialist communicates with insurance carriers by telephone, email, fax, and payor websites to support appropriate and compliant payment for services. The role reviews reports to identify trends and works with management to address front-end errors, and follows up on claims that are unpaid or incorrectly paid. The position supports Eskenazi Health’s mission to advocate, care, teach, and serve, with special emphasis on Marion County’s vulnerable population, and models the organization’s values of professionalism, respect, innovation, development, and excellence. It maintains department production and quality standards, resolves inquiries from internal and external customers, analyzes denials and other billing issues, and contributes to efficient work-queue management. The role is full-time, scheduled for day shifts.

Requirements

Associate degree in a business-related field, or technical training in coding and/or billing in lieu of the degree.
Three years of experience in a medical practice or hospital setting with billing, insurance follow-up, and/or credit balance experience.
Pay close attention to detail and maintain accurate records and documentation.
Identify denial trends by provider, location, or carrier and work with management to educate or resolve errors and prevent back-end denials.
Willingness and ability to assist other team members.
Strong problem-solving skills and ability to cooperate with others.
Ability to work independently and efficiently.
Working knowledge of Microsoft Office software and Windows.
Ability to use calculators, printers, copiers, and fax machines.
Strong math skills.
Strong organizational skills and ability to work efficiently in a high-volume, multitask environment and meet deadlines.
Professional and appropriate communication skills.
Advanced understanding of health insurance medical policies and billing requirements, including government and managed-care programs, traditional Medicaid, Medicare replacement plans, commercial carriers, HIP, and Anthem.
Ability to meet department production and accuracy requirements.

Nice To Haves

CPC certification.
Experience in dental, vision, behavioral health, and/or DME.

Responsibilities

Contribute to Eskenazi Health’s mission and model its organizational values.
Assist customer service by following up on patient calls in a timely manner.
Maintain weekly production and monthly quality measures.
Communicate effectively with internal and external customers.
Work independently while seeking guidance as needed to comply with federal, state, and hospital insurance-billing policies.
Initiate appropriate problem-solving actions and resolution.
Analyze claim denials and determine the best course of action to resolve issues and obtain appropriate payment.
Verify and update insurance and demographic information on claims when needed.
Resolve inquiries from internal and external customers.
Participate in special projects as requested.
Gather and distribute insurance information through verbal or written communication to support sufficient cash flow.
Analyze and resolve issues reported by the self-pay outsource vendor.
Use interpersonal communication skills with patients, families, and others to achieve appropriate outcomes.
Cover for coworkers as needed due to paid time off or illness.
Continue learning payor guidelines and requirements for appropriate billing.
Enter daily charges for the NTP clinic.
Complete charge review accurately and promptly to support appropriate billing of services.
Investigate and resolve claim edits, internal and external rejections, DNB, stop bills, follow-up issues, variances, denials, appeals, credit balances, and correspondence.
Manage work queues, including filters and rules, to improve workflow efficiency.
Follow up on unpaid claims with insurance companies.
Initiate billing and charge-review resolution.