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Accounts Receivable Specialist I
1 month ago
The Accounts Receivable Specialist I (ARSI) will be responsible for following up with insurance carriers on aged, unresolved claims. This position requires a comprehensive understanding of the operational aspects of the entire revenue cycle as well as the appropriate measures to take in resolving claim issues with payers. This role will work closely with the Revenue Cycle Manager and Patient Access department. Importantly, the ARSI will also ensure compliance with all applicable laws and regulations as well as CND policies.
Job Responsibilities:
- Conduct follow-up on aging accounts by contacting third-party payers via website, telephone, mail for payment status.
- Manage outbound insurance calls efficiently, navigating through various software systems seamlessly.
- Assess information received from clinics to determine the appropriate insurance to bill, acquiring necessary attachments or supporting documentation for each claim.
- Ensure the accuracy and integrity of each billed claim
- Meet specified goals and objectives as assigned by management.
- Cultivate strong working relationships with state and federal agencies. Resolve accounts promptly while maintaining confidentiality of account information.
- Assist with other projects as assigned by management.
- Investigate and resolve discrepancies in charges, working towards equitable resolutions.
- Address escalated inbound RCM calls.
- Address RCM email correspondence.
- Collaborate with the Revenue Cycle Team and Manager to prioritize assignments based on current issues and business requirements.
Knowledge, Skills & Experience:
- Minimum of 3+ years of hands-on experience in medical billing and revenue cycle management, with a distinct focus on laboratory billing preferred.
- Experience with Salesforce, Waystar, TriZetto, and Quadax is a plus.
- Knowledge of business processes, accounting principles, billing practices, medical terms, CPT, and ICD10 coding
- Demonstrate a robust understanding of the revenue cycle, coupled with practical expertise in navigating its intricacies.
- Knowledge of Medicare, Medicaid, Tricare, and other federal and commercial insurance
- Demonstrates a strong commitment to continuous learning by staying abreast of updates and changes in the ICD-10 and CPT coding system.
- Excellent written, verbal, and interpersonal communication skills are essential, and one must communicate technical concepts clearly to a diverse audience.
- Demonstrated professional poise and empathy when dealing with patients and clinics, fostering positive relationships and enhancing the overall customer experience.
- Possess advanced problem-solving and analytics skills, capable of addressing complex billing challenges with precision and efficiency.
- Ability to multitask, efficiently managing concurrent tasks and priorities.
- Must be highly proficient in Excel and data analysis.
- Exhibit strong computer-based skills, particularly in Microsoft Word, PowerPoint, Salesforce, Medisoft, and other relevant software applications essential for seamless operations in medical billing and revenue cycle management.
Education, Certifications & Licensures:
- High School diploma or general education degree required.
- Related coursework or education (e.g., billing certificate, AA, or bachelor's degree) with a focus on billing or related area preferred.
Special Training:
- Salesforce, Quadax, TriZetto, Waystar
Other:
- Bilingual in Spanish and English required.
- This is a full-time remote opportunity for the PST time zone.
- Occasional on-site presence in the Atlanta regional office or quarterly travel to CND's Scottsdale headquarters may be required.
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