Accounts Receivable Specialist - Healthcare

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

Job Requirements:

• 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