A/R Specialist

JOB SUMMARY

The Accounts Receivable (A/R) Specialist works the account follow up workflow cycle from beginning to end. Review, process, and bill EMR invoices, work with primary, secondary, and tertiary insurance carriers, remittance review and interpretation, payment posting, involves verbal and written collection efforts, when necessary, ledger balancing, account balancing, participate in and manage complex projects for the department, customer service for outbound or inbound calls, report internal processing errors, and all other responsibilities / tasks as required, ongoing, and assigned.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Evaluates correspondence, denials, reimbursement and customer reaction to identify need for process changes.
• Communicates directly with the payor, resubmits denied claims, underpaid claims and claims that are inaccurately processed by auditing accounts to check on proper payments, coding, balances, adjustments, etc. and also using appropriate reports and working queues
• Tracks and documents all denials by payor, visit type and denial category
• Identifies, documents, and communicates trends in recurring denials and recommends process improvements or system edits to eliminate future denials
• Works with the payors to understand specific reasons for denials and preventable measures available to prohibit future denials.
• Monitoring the payments to assure appropriate reimbursement from the third-party payers and informing management if payment is other than expected.
• Process patient refunds in a timely manner, submitting refund requests as the time of insurance payment/EOB receipt.
• Provide financial counseling to customers who present payments at the counter or on the phone and need to arrange an approved payment plan.
• Coordinates with management on a daily and monthly balancing of accounts receivable to general ledger.
• Review and analyze any past due amounts using aged accounts receivable reports including both patient and insurance accounts.
• Access and update payer websites for authorizations, eligibility, and claims status. And hold confidential all passwords obtained through the various payer sites.
• Meets quality and productivity standards and deadlines established by management.
• Perform additional duties as requested by management team.

MINIMUM REQUIREMENTS

• Two (2) years’ experience in working Denied A/R, underpaid medical accounts, third-party billing and payment methodologies required.
• Two (2) years’ previous experience in CPT and ICD-10 coding; familiarity with medical terminology.
• High School diploma/ GED required / Bachelor’s degree in accounting preferred.
• Competent utilizing Microsoft Office Excel and Word.

• Excellent written and verbal communication skills
• Excellent customer service skills comfortable answering both patient and insurance company questions

· Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement.

Job Type: Full-time

Pay: $18.00 - $23.89 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid sick time
• Paid time off
• Vision insurance

Physical setting:

• Office

Schedule:

• 8 hour shift
• Monday to Friday

COVID-19 considerations:
no

Ability to commute/relocate:

• San Antonio, TX 78258: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Accounting: 2 years (Required)
• Microsoft Excel: 1 year (Required)

Work Location: One location