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Accounts Receivable Specialist - Medical Billing - Remote, OR

Quick Facts
Company Name:AMAC
Location:Remote, OR
Employment Type:Full Time
Category:Medical Insurance
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Description

JOB FUNCTIONS

  • The primary responsibility of the AR Specialist is to actively work assigned clients accounts receivable, and rapidly respond to telephone inquiries from patients & staff.
  • Works and coordinates with RCM to ensure smooth and efficient operation in all areas of accounts receivable
  • Works necessary reports to ensure assigned client AR is actively worked & maintained
  • Serves as client/patient support to assigned clients

  • ACCOUNTS RECEIVABLE RESPONSIBILITIES
    • Works Denials Daily
      • File Rejected
      • Denial Report
      • In Progress Non-Primary
      • Sent Secondary Crossover
  • Review Bad Address report weekly
    • Update patients address in Centricity when report provides updated information
    • Those without new information, send list to practice contact with MRN # advise mail being returned need update, or log-in to EMR, any changes or updates then made to the patients account in Centricity.
  • Bill Status Report Hold Charges
    • Reviews charges on hold weekly, and coordinates with charge processor to ensure timely release of charges to avoid untimely filing

  • CLAIM SUBMISSIONS/CORRECTIONS
    • Will review, prepare, and submit claims to third party payers (primary and secondary) according to established policies and procedures

  • DEMOGRAPHICS
    • Will retrieve, review, verify benefits, obtain pre-authorization, and update new insurance information as needed
    • Move demographic files to GeBBs daily for assigned clients
    • Sign-off on Daily Client Charge Log for demographics;
    • Sign-off on Month-end Log by 5th business day of the month

  • CORRESPONDENCE
    • Receives and processes miscellaneous correspondence from patients, insurance companies and clients within 48 hours
    • Accounts Receivable follow-up
    • Pulls EOB's

  • REFUNDS
    • Will actively review, prepare, and submit:
      • Refund requests
      • Account adjustments

  • COLLECTIONS
  • INSURANCE COLLECTIONS

  • Run Stop report monthly. The STOP report is used to identify, and facilitate successful collection of both patient and unpaid insurance claims upon completion of patients course of treatment
    • Identify unpaid claims, actively work, and follow-up for successful collection
    • Monitor insurance & patient balances, and actively move claims through the collections process including establishing & monitoring payment arrangements.

  • AGING REPORTS/COLLECTION EFFORTS EXHAUSTED
    • Aging by Financial Class, Patient, and Insurance Carrier
    • And any other reports identified to assist in this process by RCM

  • PATIENT COLLECTIONS:
    • Will review, prepare and submit patient supplemental bills to patient(s)
    • Assist with payment arrangements, monitor, & follow-up for collection
    • Identify Self-pay patients for assigned clients;
    • verify monthly eligibility with Medicaid
    • follow-up with practice charity status
    • Assists in processing credit card payments from patients

  • Maintain current list of medical policies for the various procedures, and or diagnosis covered by those entities
  • Ensure all corporate guidelines are maintained and practiced daily
  • Maintain a "Team Player" attitude at all times
  • Communicate professionally with management, Client's staff, and peers
  • Identify and Report Denial Trends to RCM
  • Knowledge of interpreting and posting Insurance EOBs is required.
  • Review, analyze, and assist in resolving account credit balances
  • Attend AMAC-USA Webinars
  • Other projects as assigned Minimum 3 years Experience in Medical Accounts Receivable in a Physician's office or Freestanding Clinic. Experience in Radiation Oncology preferred.