Specialist, Accounts Receivable

Summit Health•Rocky Hill, CT

8d•Onsite

About The Position

This position serves to drive efficient, compliant, and effective claims and denials processing to optimize reimbursement for the organization. The responsibilities of this role include denied claims and A/R follow up with various payers including but not limited to the following: Commercial Insurances, Medicare, Medicaid, Uninsured Patients, Workers Compensation and First Aid, Occupation Medicine, and other reimbursement categories.

Requirements

High School Diploma, GED or Equivalent Required
Prior medical billing and healthcare insurance knowledge
Intermediate MS Word, Excel, Google (GMAIL, G Drive) necessary
Solid understanding of state laws and insurance fee schedules and their impacts on billing and collection
Excellent oral and written communication skills
Excellent organizational and multitasking skills
Flexible and approachable to colleagues and inter-departmental stakeholders
Ability to perform functions at established CityMD RCM Support Center

Nice To Haves

Minimum of 2-4 successful years in a business collection environment preferred
Workers Compensation and No Fault prior billing experience a plus

Responsibilities

Collect delinquent outstanding balances as quickly as possible by applying collection best practices as defined by the Standard Operating Procedures and training protocols and/or as defined by the AR manager
Primary accountability for specific AR scope/function (for example: Commercial or Uninsured or Worker’s Compensation, etc.)
Utilize various AR reports to target aged balances for collection in order to meet and maintain performance goals as set by Management.
Evaluate denials and partial payments to determine if further reimbursement is valid
Effectively participate during team meeting, payer discussions/meetings and conference calls/meetings as needed
Research and correct cash application of misapplied funds and payments on patient accounts as necessary
Identify and request adjustments to insurance and patient accounts as necessary, while following departmental procedures and policies related to overpayments and credits and refunds
Ability to consistently maintain productivity and quality expectations as defined by management
Alert management to irregularities, insurance trends and areas of concern with reimbursement
Ability to maintain confidentiality of all information under HIPPA guidelines and policies and maintain PHI integrity
Responsible for assisting in any new hire training within the AR Management team
Responsible for assisting all new Rev Cycle cross-team members in the onboarding and training process to educate new CityMD employees on AR Management
Assists other departments within the Revenue Cycle department with various tasks/duties as assigned