Accounts Receivable Specialist

Carolina Digestive Health Associates PA • Charlotte, NC

88d

About The Position

The Accounts Receivable Specialist is responsible for payer-specific claim follow up to encourage stable AR metrics and revenue.

Requirements

• High School Diploma or GED.
• Minimum two years in medical billing or hospital coding, as a claims processor, medical claims for an insurance carrier, or clerical/billing experience in a medical office preferred.
• Knowledge of medical billing software.
• Must be able to successfully interpret Explanation of Benefits and Electronic Remittance Advice statements.
• Excellent organizational, problem-solving and critical thinking skills are required.
• Must be a team player and able to work with various departments throughout the organization.
• The ability to maintain confidentiality is required.
• Ability to communicate effectively both verbally and in writing.
• Participates in performance improvement activities.
• Is actively committed to meeting or exceeding employee expectations/satisfaction in the performance of job functions.
• Retains all accreditations, licensures, and designations in good standing.
• Maintains compliance with all laws and applicable regulatory requirements. Acts promptly to comply with required changes.

Responsibilities

• Review payer aging reports to identify issues with timeliness, accuracy, and completeness of reimbursement.
• Identify and resolve claim denial/non-payment patterns.
• Review patient balances for self-pay collections.
• Initiate claim appeals where appropriate.
• Manage rejected and invalid claims.
• Respond to patient requests regarding billing questions/concerns.
• Review credit balances for accuracy prior to generating refund requests.
• Keep abreast of changes in Medicare, Medicaid, and insurance providers regarding pre-certification procedures.
• Possess working knowledge of CPT codes, ICD10 codes and Medical Terminology.
• Uphold the CDHA mission by actively contributing to the achievement of organizational goals, supporting leadership, promoting unity and teamwork for the benefit of patients.
• Demonstrate a commitment to quality of care.
• Maintain a clear focus on patient safety in every interaction with every patient.
• Actively participate in workplace improvement to maintain a patient service excellence environment.
• Adhere to all industry standards related to infection control, patient confidentiality, and regulatory and accrediting body's requirements (i.e. HIPAA, OSHA, and AAAHC).
• Follow and comply with all safety policies.
• Additional duties as assigned within the scope of responsibility.

What This Job Offers

• Education Level: High school or GED