About The Role

The Billing & Accounts Receivable Specialist is responsible for the accurate and timely execution of all billing functions, including electronic and paper claim submission, patient eligibility verification, payment collection, accounts receivable follow-up, and authorization tracking. This role works closely with Registrars and internal departments to ensure compliance with financial policies, payer requirements, and overall revenue cycle efficiency.

Duties and Responsibilities

Submit all electronic claims within established timeframes.
Complete and process all paper claims accurately and timely.
Verify and document patient insurance eligibility and benefits prior to billing.
Identify patient financial responsibility and ensure accurate billing of copays, deductibles, and coinsurance.
Collect patient payments, including point-of-service collections when applicable.
Monitor and follow up on assigned accounts receivable, including both insurance and patient balances, to ensure timely resolution.
Conduct follow-up on outstanding patient AR, including statement review, payment arrangements, and escalation as needed.
Monitor assigned accounts to ensure compliance with financial policies and timely reimbursement.
Collect required data and prepare reports for external funding sources.
Collaborate with Registrars to ensure accurate patient demographics, insurance information, and compliance with financial policies.
Track and analyze payer trends; communicate findings to the CBO Manager.
Evaluate billing processes for efficiency and recommend improvements.
Communicate with private insurance companies to resolve billing issues and disputes.
Respond to patient billing inquiries in a professional and timely manner.
Complete daily Avatar Central Billing reports.
Accurately post payments and denials in Avatar according to contracted rates.
Maintain a minimum productivity standard of 100 hospital charges entered per day.
Ensure all PIP charges are entered on the same day they are received.
Monitor Avatar reports to confirm billing slips are received within 5 days of patient discharge and follow up with the CBO Manager as needed.

Minimal Qualifications

Education: High School Diploma or equivalent.

Experience: One (1) year in clerical positions such as receptionists, data entry specialists, administrative assistants, file clerks, and front desk agents. Healthcare experience preferred but not required.

Training: Training in relevant computer programs – Avatar, Smart, Cerner

Equipment Use: Computer, copier, facsimile, and shredder.

The above statement reflects the general details considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.