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Accounts Receivable Specialist
3 months ago
With 150+ locations in 17 states, QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S. At QualDerm Partners, we are united in our purpose: to educate, protect, and care for your skin. We are committed to bringing you the very best in comprehensive skin care so that you can achieve a confident, healthier, and more beautiful you
Our mission is to educate communities and healthcare professionals about the importance of skin health; including skin cancer prevention, risk factors and how to achieve healthy skin through annual skin exams and dermatologic care. We strive to provide the latest proven, proactive and comprehensive dermatologic care to populations in the expanding geographies we serve by making high-quality skin care timelier and more accessible all while creating a rewarding work environment for our providers and employees.
Position Summary
This position works with a professional team of physicians and other staff who are trained in the medical and surgical specialty of dermatology with the purpose to be patient focused with the objective of delivering superior patient care and ensuring a positive patient experience and outcome.
The Accounts Receivable Specialist is responsible for all day-to-day billing, claims issues, denials and follow-up for their assigned region/locations. Position proactively researches, identifies, and rectifies any circumstance affecting delayed submission or payment of accounts. Position communicates accounts receivable issues proactively to management to ensure compliance and accuracy. Position performs various administrative and clerical duties needed to support revenue cycle functions as needed. Position reports to the Manager, Accounts Receivable and/or Senior Director, Credentialing and Revenue Cycle.
Essential Responsibilities
- Ability to identify the cause of claim denials and resolve them, with minimal assistance.
- Analyze problems and report trends related to denials and payer trends.
- Follow up on unpaid claims within standard billing cycle timeframe.
- Prepare and submit corrected/replacement claims, reconsiderations, appeals, medical documentation and other necessary documents to payers via fax, provider portals, etc.
- Make outbound calls to payers to resolve claims and payment issues.
- Ensure the patient’s medical information is accurate and up to date.
- Meets productivity requirements as established by organization and external benchmarks.
- Provides necessary reporting and communication of any accounts receivable issues directly to the team lead.
- Effectively uses billing system to document patient accounts using proper grammar, spelling, and syntax.
- Provide team lead with administrative assistance when needed including assisting with internal/external audits.
- Maintains current knowledge in regards policies and guidelines for all payers.
- Adheres to Code of Conduct and Mission & Values Statement.
- In addition to the above job responsibilities, other duties and projects maybe assigned
Education and/or Experience Requirements
- High School graduate or equivalent.
- Education in medical billing or hold medical billing certification preferred.
- Mod Med/EMA practice management system experience is a plus.
Qualifications
- Must be highly professional and an effective communicator.
- Detail and results oriented, self-starter with a positive attitude
- Be able to multitask, prioritize, and manage time efficiently while in a remote working environment.
- Understanding of basic principles of revenue cycle, accounts receivables, denial management and coding (CPT/HCPCS/ICD10).
- Eagerness to learn and adapt quickly in a changing environment.
- Ability to maintain a high level of integrity and confidentiality of medical information
Benefits of Joining QualDerm Partners
- Competitive Pay
- Medical, dental, and vision
- 401(k) - 100% for the first 3% of contribution and 50% for the next 2% of contribution
- Paid Time Off - accrual starts upon hire, plus 6 Paid Holidays and 2 floating holidays
- Company paid life insurance and additional coverage available
- Short-term and long-term disability, accident and critical illness, and identity theft protection plans
- Employee Assistance Program (EAP)
- Employee Discounts
- Employee Referral Bonus Program
QualDerm Partners is proud to be an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Applicants must be currently authorized to work in the United States in a full-time basis.
Requirements: