Job Description

The Accounts Receivable Specialist is responsible for researching outstanding balances and determining correct action to be taken to ensure maximum reimbursement. Must take the lead on corrective actions for accounts with outstanding balances in a timely manner to obtain reimbursement. Responsible for processing correspondence relating to the financial status of an account. Responsible for recognizing trends for denials and reimbursement issues and reporting such to the Billing Supervisor & /or Director Revenue Cycle.

Work is typically performed in an office environment, but this position has the option to work from home but may also be needed onsite for projects or team meetings from time to time. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements for this job description are not intended to be all inclusive. They represent typical elements considered necessary to successfully perform the job.

REPORTING RELATIONSHIPS

The position reports to the Director of Revenue Cycle. No staff report to this position.

ESSENTIAL JOB DUTIES and FUNCTIONS

While living and demonstrating our Core Values, the Accounts Receivable Specialist will:

• Manage outstanding accounts receivable. Resolve outstanding balances, resubmitting claims and providing necessary information to support prompt payment. Parties which may be contacted to resolve an outstanding balance include but are not limited to patients, responsible parties, insurance carriers, case managers, employers, referring providers, attorneys and facility personnel
• Follow up on outstanding accounts receivable, focusing on maintaining aged receivables within 90 days of days outstanding. Includes researching aged account reports, outstanding “to-do” list, and processing problematic EOB’s
• Identify, correct and communicate payment posting errors to staff
• Make all necessary corrections in the billing system. Research and resolve claims rejected by payer
• Identify billing and coverage concerns. Communicate with billing and front office staff regarding billing requirements not being met
• Answer patient and facility questions about account balance and status of payment
• Identify, correct and communicate facility errors to appropriate parties involved and produce corrective action plans accordingly
• Identify and communicate payment trends to Supervisor & /or Director Revenue Cycle, related to payers, CPT codes, diagnosis codes, etc
• Research outstanding credit balances and prepare requests for refunds
• Research and recommend accounts for bad debt write off
• Assist to develop a strategy the team will use to reach goals and maintain high level of productivity
• Provide training that team members may need and monitor progress
• Create reports to update the organization on Billing Department progress
• Other duties as assigned by management

Requirements

QUALIFICATIONS

• Meet The Wright Center for Community Health and its affiliated entity The Wright Center for Graduate Medical Education EOS© People Analyzer Tool
• Buy in and experience working in the EOS® model (strongly preferred)
• Mission-oriented; represents the enterprise in a professional manner while demonstrating organizational pride
• High school degree or equivalent required
• 1 - 3 years medical billing/claims experience
• Knowledge of EOBs, EFTs and ERAs
• Experience in CPT codes and ICD 10 coding preferred
• Experience with electronic medical records preferred
• FQHC billing and payment posting preferred, but will train the right candidate
• Medent experience preferred
• Knowledge of Microsoft Office software
• Must be focused, self-directed, organized, and have demonstrated problem-solving abilities
• Accurate and precise attention to detail
• Excellent verbal and written communication skills
• Able to work both independently and as part of a team