Accounts Receivable Specialist - Healthcare
Orlando, FL 32804 US
Qualified candidates will have experience with revenue cycle management and customer service in the healthcare industry. Thorough knowledge of CPT and ICD-9 codes and familiarity with the upcoming ICD-10 transition is necessary. Preferred in-depth knowledge of the billing and collections process for Medicare, Medicaid as well as commercial and third-party carriers is a must and experience in reading EOB's desired. Additional qualifications include strong technical and report analysis skills and a strong customer focus.
Responsibilities (include but are not limited to):
- Review HCFAs and electronic edits for submissions and rejections to insurance companies
- Processing and posting of payments, research and follow up on unresolved payment issues and zero EOB's.
- Receive and initiate patient calls to resolve billing or payment concerns
- Research, review and communicate with insurance carriers regarding open accounts receivables
- Review, research and initiate collections procedures with outside agency
- Researching and analyzing accounts, communicating with insurance payers and patients and recording clear and accurate notes for management as well as maintaining the appropriate documentation.
- Ability to learn what each denial code represents and be able to determine the next course of action
- Minimum 2 to 5 years of Healthcare Billing and Collection experience is required
- Knowledge of Excel, word, various insurance portals, TSI systems, and clearing houses are a must
- Basic understanding of the benefits investigation process (deductible, out-of-pocket, benefit exclusions; etc.
- Working knowledge of reimbursement claim forms (CMS/HFCA-1500 required)
- Analytical and problems solving skills, detail and results oriented.
- Knowledge of Managed Care, Commercial Insurance, Medicare and Medicaid reimbursement
- Must possess good written and oral communication skills with the ability to interface with patients and company personnel at all levels
Equal Opportunity Employer