AR Specialist

EyeHealth Northwest•Milwaukie, OR

3d•Onsite

About The Position

Accounts Receivable Specialists prepare and process claims, including adjustments, for submission to primary, secondary, and tertiary insurance companies. They receive and apply payments to patient accounts and represent EHN professionally. The role has no supervisory responsibility, but may provide guidance to employees and assist with orientation and training of new employees in the work group. Most work is performed in a general office environment that is well-lit, well-ventilated, fast-paced, and subject to low to moderate noise. The position requires manual and finger dexterity, frequent extended sitting and talking, and occasional reaching, lifting, pushing, pulling, or carrying objects weighing up to 35 pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Requirements

High school diploma or equivalent.
At least two years of relevant experience.
Knowledge of generally accepted office practices, procedures, and equipment.
Ability to read and understand written and verbal communication.
Computer literacy and proficiency with Windows-based programs.
Ability to operate standard office equipment, including a copier, postage machine, printers, and a 10-key by touch.
Ability to work cooperatively and interact professionally and respectfully with physicians, staff, vendors, and patients.
Clear and concise oral and written communication skills.
Attention to detail.
Ability to maintain a high degree of confidentiality.
Knowledge of medical billing procedures, including CPT and ICD-10 coding, and familiarity with HCPC coding.
Ability to perform the essential functions of the role, with reasonable accommodations where applicable.

Responsibilities

Process charges billed directly to medical and vision insurers and review and process paper and electronic claims daily.
Prepare bills, invoices, account statements, and other financial records according to established procedures.
Review and research patient accounts to ensure third-party billing details are adequate.
Audit insurance claims for accurate charges, ICD-10 and CPT codes, and contractual requirements; identify and resolve coding discrepancies.
Investigate, resolve, and process claim denials; correct claims denied by electronic edits and resubmit them according to payer guidelines.
Receive payments and post amounts paid to patient accounts.
Locate and monitor overdue accounts.
Respond to and research patient account inquiries and provide customer service at every interaction.
Update patient account, patient data, and insurance information in a timely manner, and purge records of deceased patients.
Coordinate with clinic staff to ensure patient data and claim information are accurate and complete.
Notify a supervisor or Director of discrepancies or problems with accounts receivable processes or payer issues.
Process and apply overpayments and refunds to patient accounts in a timely manner.
Post Nextgen batches daily and follow up on accounts receivable issues in a timely manner.
Maintain the security and confidentiality of patient account information.
Perform work in compliance with company policy, department procedures, and regulatory requirements, including HIPAA.
Maintain the file room, process returned mail, sort and file correspondence, and perform miscellaneous clerical duties such as answering correspondence and writing reports.
Cross-train on other duties and perform other work that supports patients, the department, and the company.