Job Description

An Accounts Receivable Specialist II is responsible for resolving outstanding insurance balances of moderate to high complexity. Responsible for following up with payers via telephone, website, letter, or fax in order to resolve outstanding balances as quickly as possible.

Job Responsibilities

• Resolves higher dollar, aged accounts receivable to determine why a claim has not be paid and takes necessary actions to get claim paid immediately.
• Promptly resolves denials by identifying the root cause of the issue and then taking any necessary actions to get denial overturned and paid promptly.
• Works with payers, departments, management and patient (if required) to obtain necessary information for claim resolution.
• 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.
• Proactively escalates unresolved questions or issues. Shares information as necessary.
• Other duties as assigned.

Education Requirements

• High school diploma or GED

Experience Requirements

• Minimum: Two (2) years of experience working with insurance balances in a business office or similar role.
• Preferred: Three (3) years of insurance follow-up experience working in Epic EMR handling claims of moderate to high complexity

License/Certification Requirements

• None