Revenue Cycle Accounts Receivables Specialist (103622)

Description

• SECTION 1: Job Summary (Summary of the basic functions of the position)
• \Responsible for accounts receivables management and general medical billing for insurance companies
• (payors) and patients focused primarily on maximizing collections. Serves as a liaison between practices,
• clinics, the business office, payors, and patients. Establishes and maintains contacts with payor accounts’
• representatives. Initiates telephone contact and answers all calls pertaining to accounts. Maintains
• accurate information regarding patient accounts receivables status. Maintains strict confidentiality for all
• patient accounts. Follows approved processes, policies and procedures in executing job duties.
• SECTION 2: Duties and Responsibilities (Responsibilities necessary to accomplish job functions)

• Follows-up on unpaid insurance claims after denial, to obtain settlement of claim.
• Keys data into computer to maintain billing records and prepare insurance form with data such as names of insurance company and policy holder, policy number, and physician diagnosis.
• Contacts insurance company to verify patient coverage and obtain information concerning extent of benefits.
• Generates appropriate paper work, including insurance claim forms (original and re-filed) and collection letters, mails monthly statements to patients.
• Reviews all insurance claim forms for accuracy and makes appropriate corrections for refiling.
• Reviews all insurance payments (Explanation of Benefits – EOB’s), including Medicare and Medicaid payments for accuracy in account information and demographics.
• Determines adjustments of claims paid at the out-of-network rate to in-network rates, and processes write-offs on these adjustments.
• Reposts payments, including insurance and patient payments to appropriate accounts as necessary.
• Answers patients' questions regarding statements and insurance coverage, answers telephone in a prompt, courteous, and helpful manner, screening calls, directing calls, providing information, answering questions, and taking accurate messages.
• Responds to all inquiries received from patients and payors either by telephone or written request
• Establishes and maintains contacts with payor accounts’ representatives.
• Reviews accounts receivable activities and calls on outstanding balances or claims.
• Processes patient refunds as needed.
• Handles transactions necessary on discharged patients.
• Completes and files all necessary paperwork for services rendered, i.e., charge tickets, patient forms, medical records, etc.
• Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.
• Performs other duties that may be necessary or in the best interest of the organization

Qualifications

SECTION 3: Experience Requirements

• Three (3)+ years of work experience in medical billing and accounting experience.

SECTION 4: Knowledge, Skills and Abilities Requirements

• Thorough knowledge of medical accounts receivable collection procedures, including knowledge of insurance correspondence required.
• Thorough knowledge of Medicare rules and regulations.
• Thorough knowledge of medical billing procedures and medical insurance, including credit and collection procedures required.
• Detail oriented, professional attitude, reliable
• Strives to achieve US Dermatology Partners Standard Key Performance Indicators (KPIs)
• Management and organizational skills to support the leadership of this function
• Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations
• Interpersonal skills to support customer service, functional, and team mate support needs
• Able to communicate effectively in English, both verbally and in writing
• Mathematical and/or analytical ability for basic to intermediate problem solving
• Basic to intermediate computer operation
• Proficiency with Microsoft Excel, Word, and Outlook
• Specialty knowledge of systems relating to job function
• Knowledge of state and federal regulations for this position; general understanding of HIPAA guidelines

SECTION 5: Supervisory Responsibilities

• This position has no supervisory responsibilities.

Benefits

• Medical, Dental, & Vision
• 401k
• PTO & Paid Holidays
• Company Paid Life Insurance
• Employee Perks Program