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Accounts Receivable Specialist
1 month ago
Location: On-site in Spring, TX and Houston, TX with expected work hours from 8:30 AM to 5PM CT Mon-Fri.
Must be able to work in-office at Spring, TX and Houston, TX location
Hybrid schedule is an option
Skills Required
Ideal candidate will have healthcare front desk experience PLUS medical billing experience
NextGen software experience is a plus
Must have experience with denials management
Must be comfortable with insurance follow-ups and verification
Must be able to read EOBs
Minimum 2 years of medical billing/insurance verification/AR
College degree is a plus
Summary Description:
The Accounts Receivable Specialist will be responsible for hospital compliance and quality improvement programs and will monitor compliance with billing rules/regulations by conducting reviews/audits of medical record notes to the billing department; evaluate the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices lead to appropriate execution of regulatory requirements and guidelines related to facility and technical fee documentation, coding and billing, including federal and state regulations and guidelines, CMS and other third party payor billing rules, and OIG compliance standards.
Job Responsibilities:
Interact with internal departments such as Customer Service, Medical Management, Configuration, Contracting, Claims, and Provider Relations, as well as providers and other external entities, to process provider disputes efficiently and appropriately.
Conduct standardized audit scoring methodology to consistently evaluate documentation and coding, and standardized audit findings methodology to report audit results.
Communicate audit results to hospital service departments and departmental leadership, physicians, physician leadership, senior hospital management, coders, billers and other appropriate staff, provide physician and coder education and make recommendations for management corrective action.
Serve as institutional subject matter experts and authoritative resources on interpretation and application of documentation and coding rules and regulations, medical necessity of services delivered, and conduct enterprise risk assessments of potential and detected compliance deficiencies.
Investigate provider disputes to determine the source of the complaint.
Use appropriate, understandable correspondence to communicate decisions.
Ensure revenue integrity
Maintain CDI process
Responsible for charge capture
Work directly with the manager to meet the needs of the department.
Other departmental Ad Hoc Payment Integrity functions
Skills and Education:
Understanding of Medicare and Medicaid billing rules. Knowledge of Microsoft Office Suite software.
A bachelor's or associate's degree in a related field is preferred.
2 years of experience in health insurance/managed care.
Knowledge of medical terminology is preferred.
Excellent written and oral communication skills
Microsoft office products will be included in PC proficiency.
The option of a hybrid schedule will be considered.
Company Benefits and Perks:
Joining us comes with an array of benefits, flexible work hours when possible, and a genuine sense of belonging to a dynamic and growing organization.
Access to a 401(k) Retirement Savings Plan.
Comprehensive Medical, Dental, and Vision Coverage.
Paid Time Off
Paid Holidays.
Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services.
If you are a dedicated and experienced AR Specialist ready to contribute to our mission and be part of our diverse and inclusive community, we invite you to apply and join our team.
Job Type: Full-time
Pay: $18.00 - $22.00 per hour
Benefits:
401(k)
Dental insurance
Employee assistance program
Employee discount
Health insurance
Paid time off
Retirement plan
Vision insurance
Schedule:
Monday to Friday
Experience:
Accounts receivable: 3 years (Required)
denials management: 2 years (Required)
Insurance follow-ups and verification: 1 year (Required)
healthcare front desk and medical billing: 2 years (Required)
Ability to Relocate:
Spring, TX 77373: Relocate before starting work (Required)
Work Location: In person
