PMC Accounts Receivable Specialist

Preferred Management Corporation•Shawnee, OK

11d•Onsite

About The Position

The PMC Accounts Receivable Specialist will be responsible for processing Medicare, Medicaid, Worker’s Compensation, and Third Party Payer claims. This role requires knowledge of bookkeeping, computer skills related to claims processing, and strong organizational abilities to work independently. The specialist will manage accounts receivable, follow up on collections, provide customer service to patients, and ensure the accuracy and submission of all claims.

Requirements

Communicates in an effective manner, follow written or verbal instructions and demonstrates good interpersonal skills to deal with team members, patients and families.
Knowledge of insurance policies.
Competent with the accounts receivable accounting system.
Competent in Microsoft Office Word and Excel.
Maintain discretion and confidentiality in communications.
Familiar with policies and procedures regarding reporting and release of protected health information (PHI).
High School Diploma/GED
1 year experience in bookkeeping, clerical and applicable computer training
Communicate verbally and in writing in English.
Must be proficient at mathematical and statistical calculations.
Employee responds to unusual or varied situations that are not covered by existing standards, procedures and precedents.

Nice To Haves

Prior physician office or medical coding, preferred
MediTech Experience, preferred

Responsibilities

Demonstrates knowledge and ability to follow medical billing practices.
Demonstrates knowledge of Level I Healthcare Common Procedure Coding Systems (HCPCS) comprised of Current Procedural Terminology (CPT-4) and International Classification of Diseases (ICD) codes.
Demonstrates knowledge of Medicare, Medicaid, Insurance Managed Care Plans and Workmen’s Compensation.
Manages Accounts Receivable effectively, reviewing with manager problem claims.
Reads and monitors bulletins from plans subscribed to for changes and updates in claims submission.
Follow up phone calls on collections.
Gives professional customer service to patients and public at all times.
Maintains any logs necessary for collections and QA purposes.
Download Medicare receipts on accounts.
Submits all claims to Medicare, Medicaid, primary insurances, and supplemental/secondary insurances.
Enter charges for services rendered.
Re-submits claims as necessary and handles appeals process when necessary.
Researches and resolves correspondence from insurance carriers or private patients concerning claims.
Reviews and corrects claim edits and denials to ensure proper payment for services rendered.
Develops and maintains positive, effective working relationships with other employees, supervisors and medical providers.
Ensure strict confidentiality of financial and medical records under HIPAA, HIPAA Security laws and hospital/clinic policies and procedures.
Communicates clearly written and oral medical information to professional practitioners and/or the general public.
Attends meetings as required.
Miscellaneous duties as assigned requested or required.