Accounts Receivable Specialist 1 -- Remote | WFH

At our company we're dedicated to empowering healthcare organizations to tackle the most significant challenges in the industry: ensuring quality clinical care, fostering positive patient experiences, and achieving optimal financial outcomes. We collaborate closely with our clients, offering innovative solutions and revenue cycle improvement services that pave the way for their success. Rooted in our values of Commitment, Authenticity, Respect, and Excellence (CARE), we strive to make a meaningful impact on healthcare communities nationwide.

Position Title: Accounts Receivable Specialist I

Location: Remote (Alabama, Colorado, Florida, Georgia, Idaho, Kansas, Maine, Virginia, Vermont, Michigan, North Carolina, South Carolina, Tennessee, Texas, Virginia, and Vermont)

Responsibilities

• Verify patient eligibility and obtain authorizations for healthcare services, utilizing payer websites, client systems, or direct communication with insurance carriers and healthcare providers.
• Update patient demographics and insurance information accurately in designated systems.
• Conduct thorough research to address unpaid or denied claims, ensuring proper documentation and follow-up.
• Monitor claims for missing information and authorization numbers, taking necessary actions for resolution.
• Review Explanation of Benefits (EOBs) and UB-04 forms to reconcile payments and adjustments.
• Communicate with payers via phone or written correspondence to secure timely claim payments.
• Utilize client systems to access payment data and track claim status efficiently.
• Adhere to prioritization guidelines, meeting filing deadlines, and maintaining accurate records within designated systems.
• Obtain necessary medical documentation as required by third-party insurance carriers.
• Prepare appeal letters for technical appeals and verify underpayments by referencing contracts and claims data.
• Assist in the preparation of claims for clinical audit processing in the event of denials related to authorization, coding, level of care, or length of stay.
• Support the company's Compliance Program by following HIPAA, FDCPA, FCRA, and other relevant regulations, including maintaining confidentiality and reporting compliance concerns.
  
  

Requirements

• High school diploma or GED equivalent.
• Minimum of two years' experience in healthcare insurance accounts receivable follow-up, preferably within a hospital or healthcare system.
• Proficiency in identifying billing errors, resubmitting claims, and addressing payment discrepancies and denials.
• Familiarity with accounts receivable practices, medical billing procedures, and third-party payer reimbursement guidelines.
• Experience with accounts receivable software and navigating payer websites for appeals, benefits verification, and claims follow-up.
• Strong computer skills, including proficiency in Microsoft Office (particularly Excel) and internet navigation.
• Excellent communication skills, both written and verbal, with the ability to effectively interact with payers and document encounters accurately.
• Demonstrated ability to work independently and collaboratively in a team environment.
• Track record of meeting performance objectives and working towards common goals.
  
  

Salary Range: $13.13 to $20.63 per hour (specific compensation may vary based on factors such as geographic location, experience, and certifications)

Employment Type: Full-Time

Salary : $13 - $21