Accounts Receivable Specialist

BioTAB Healthcare•Maryland Heights, MO

20d•$20 - $25

About The Position

BioTAB Healthcare, LLC is a family-owned healthcare company headquartered in Missouri that provides pneumatic compression devices and personalized service to patients with lymphatic, wound, and circulatory disorders. The Accounts Receivable Specialist performs resolution-oriented activities focused on medical billing, payment posting, and collections. The role supports efficient cash collections through accurate reimbursement practices, payment processing, and/or claim billing while complying with applicable laws, regulations, company policies, and compliance programs. It emphasizes process execution and quality control and reports to AR Supervisors and/or the AR Quality & Support Supervisor. The position may cover payment posting, billing, and collections activities. Payment posting includes researching insurance payments and correspondence, matching EOBs and payment records, processing write-offs, and maintaining records for EFT, credit card, ACH, check, insurance, and patient payments. Billing includes preparing and submitting claims and patient statements, correcting rejected claims, and submitting contract billing to outsourced partners. Collections include following up on unpaid claims and patient accounts, analyzing billing discrepancies and underpayments, conducting root-cause analysis, communicating with patients, and researching and submitting appeals or rebilling claims. The specialist also supports compliance with healthcare regulations, financial standards, internal policies, Medicare requirements, and patient intake and data-management policies. Duties include preparing year-end schedules for review and regulatory agencies and supporting compliance monitoring. The role requires attention to HIPAA, Medicare Fraud, Waste, and Abuse, and privacy regulations. Duties may be modified or supplemented, and accommodations may be made for disability as applicable.

Requirements

At least one year of experience with claim submission, payment posting, appeals, and denial processes.
Experience with medical device billing and/or general healthcare reimbursement, Medicare, and commercial insurance plan configurations for coinsurance, deductibles, and percentage calculations.
Analytical ability to review data, identify trends, and make recommendations.
Excellent communication and interpersonal skills for effective collaboration.
Proficiency with accounting software and Microsoft products, including Excel.
Strong organizational and time-management skills to manage high-volume work and process information promptly.
Attention to detail in patient records and insurance information.
Problem-solving skills to address issues and challenges in the intake process and established AR workflow.
Ability to lift 40 pounds from the floor to waist level.
Ability to kneel, stoop, climb stairs, and reach with hands and arms.
Reliable work transportation.
Must pass an extensive background check.
Strict adherence to HIPAA, Medicare Fraud, Waste, and Abuse, and privacy regulations.

Nice To Haves

College degree or related previous experience.
In-depth knowledge of healthcare methodologies in coding, coverage, criteria, and payments.

Responsibilities

Research and evaluate insurance payments and correspondence for accuracy, and process or post insurance and patient payments.
Match EOBs and payment records with payments; process write-offs; batch and scan payments; and maintain applicable records.
Accurately and timely submit claims for all payers, including preparing daily submissions for primary, secondary, and tertiary payers and/or patient statements.
Review rejected claims, make corrections, and ensure claims are resubmitted as appropriate.
Submit contract billing to the appropriate outsourced partner.
Follow up on unpaid claims and patient accounts and work assigned outstanding-balance lists involving different payers and patients.
Identify trends and conduct follow-up and root-cause analysis on unpaid or underpaid insurance claims.
Analyze and resolve billing discrepancies on patient accounts and communicate findings to patients.
Draft appeals, research denials and underpayments, and perform remediation, appeals, rebilling, and payer resolution.
Comply with applicable healthcare regulations, financial standards, internal policies, and agency policies.
Prepare year-end schedules for review and regulatory agencies and assist in monitoring compliance with Medicare regulations.
Adhere to regulations and policies concerning patient intake and data management, including CMS and OFCCP guidelines related to the Quality Management System, documentation, process creation, and training.
Maintain compliance with HIPAA, Medicare Fraud, Waste, and Abuse, and privacy regulations in patient interactions.