Accounts Receivable Specialist

ThedaCare • Neenah, WI

6d • Onsite

About The Position

Summary : The Accounts Receivable Specialist submits billing to the appropriate party and follows-up for adjudication and payment of individual claims. Communicates with insurance and other payers, patients, guarantors, family members, and/or other medical staff for status of individual claims to manage accounts receivable. Job Description: KEY ACCOUNTABILITIES: Performs comparative analysis for accuracy of bill before submission to appropriate parties (i.e., charges, subscriber data, diagnosis/procedure codes, and late charges). Processes claims in a timely manner according to contracts, regulations, department standards, and form requirements. Generates phone calls to all parties to check status of unprocessed, unpaid, or rejected claims ensuring accurate and timely reimbursement. Processes variety of correspondence from all parties taking appropriate steps to expedite timely resolution of claims payment. Verifies insurance/payer and patient demographic information for accuracy of data collected at time of registration when appropriate. Inputs verification data to complete in-house claims generation of billing forms. Re-bills accounts when new information is received requiring account updates with appropriate demographic and third party information to ensure payment. Updates patient record to indicate changes made. Reviews internal and external reports for claims status.

Requirements

• High School diploma or GED preferred
• Must be 18 years of age
• Ability to move freely (standing, stooping, walking, bending, pushing, and pulling) and lift up to a maximum of twenty-five (25) pounds without assistance
• Job classification is not exposed to blood borne pathogens (blood or bodily fluids) while performing job duties

Responsibilities

• Performs comparative analysis for accuracy of bill before submission to appropriate parties (i.e., charges, subscriber data, diagnosis/procedure codes, and late charges).
• Processes claims in a timely manner according to contracts, regulations, department standards, and form requirements.
• Generates phone calls to all parties to check status of unprocessed, unpaid, or rejected claims ensuring accurate and timely reimbursement.
• Processes variety of correspondence from all parties taking appropriate steps to expedite timely resolution of claims payment.
• Verifies insurance/payer and patient demographic information for accuracy of data collected at time of registration when appropriate.
• Inputs verification data to complete in-house claims generation of billing forms.
• Re-bills accounts when new information is received requiring account updates with appropriate demographic and third party information to ensure payment.
• Updates patient record to indicate changes made.
• Reviews internal and external reports for claims status.

Benefits

• Lifestyle Engagement e.g. health coaches, relaxation rooms, health focused apps (Wonder, Ripple), mental health support
• Access & Affordability e.g. minimal or zero copays, team member cost sharing premiums, daycare

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees