Sr. A/R Specialist

OhioHealth•WORK AT HOME - OHIO, OH

About The Position

This position is responsible for submitting bills to the appropriate parties and following up on individual claims for adjudication and payment. The role communicates with patients, third-party payors, guarantors, family members, medical staff, and other hospital departments about claim status to manage accounts receivable. The position maintains accounts receivable balances, reconciles cash receipts and postings, follows up with payors, balances bills to secondary insurance and patients or families, and works with medical records to support complete and accurate billing documentation. It also verifies insurance and eligibility information, assists patients and staff with paperwork, confirms coverage, documents billing information, advises patients and families about potential financial responsibility, and coordinates billing of services to the appropriate payors. The specialist may assume the duties of the Accounts Receivable Supervisor or coworkers when they are absent, and is responsible for training new staff and cross-training other staff. Additional work includes preparing reports, maintaining paper and computer files, and participating in meetings, support activities, in-services, and retreats. Responsibilities require a focus on safety, quality, and efficiency as part of a High Reliability Organization. The job profile is an overview and may change; it is not an exhaustive list of duties.

Requirements

High school diploma or GED.
Good understanding of medical coding.
Working knowledge of medical terminology.
Ability to work as part of a team, with attention to detail and balanced concern for accuracy and efficiency.

Responsibilities

Maintain accounts receivable balances and follow up on the collection of accounts.
Reconcile cash receipts and cash postings and update records as payments are received.
Follow up regularly with payors and balance bills to secondary insurance and patients or families.
Work with medical records to ensure complete and accurate charts for billing compliance.
Report denials and billing problems to the Accounts Receivable Supervisor and prepare recertification reports.
Verify insurance information and coverage, assist with eligibility paperwork, and negotiate commercial payor per diem payments as appropriate.
Document pertinent information in patient billing files and maintain those files.
Advise patients and families of potential financial responsibility and notify payors of patient elections and discharges as appropriate.
Prepare billing forms and required documentation and bill services to the appropriate payors.
Assume the duties of the Accounts Receivable Supervisor or coworkers when they are absent.
Train new staff and cross-train other staff on responsibilities.
Collect data and prepare reports; maintain paper and computer files; participate in staff meetings, support activities, in-services, and retreats.