An Accounts Receivable Specialist is responsible for resolving outstanding insurance balances. Responsible for following up with payers via telephone, website, letter, or fax on status of claims payment in order to resolve outstanding balances as quickly as possible.
Job Responsibilities
Resolves payer requests for additional information by submitting itemized bills, medical records, EOBs, and any other necessary documentation to get claim paid.
Promptly resolves eligibility and coordination of benefits denials by identifying and updating insurance information and ensuring claim is rebilled to correct payer immediately.
Ability to use network computer software.
Works with payers on unprocessed (not paid or denied) claims to ensure payment is forthcoming in a timely manner and promptly escalates unresolved issues to appropriate parties at insurance company.
Provides feedback to supervisor and ensures collecting the information of trends and responds to inquiries about trends.
Performs any necessary account adjustments in accordance with department policies.
Ensures assigned work queues are reviewed and resolved timely.
Monitors assigned work queues and payers for identification of potential problems.
Other duties as assigned.
Education Requirements
Minimum: High School Diploma or equivalent
Preferred: Medical Certification program in healthcare
Experience Requirements
Minimum: Six (6) months or more experience within a hospital and/or medical billing office.
Preferred: A healthcare background working in medical billing, collections, insurance claims processing, coding, registration or working in a hospital business office.
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