AR Follow Up Specialist

7 days ago

Red Bank, New Jersey, United States Med-Metrix Full time
Job Summary

Med-Metrix is seeking a highly skilled AR Follow Up Specialist to join our team. As an AR Follow Up Specialist, you will be responsible for completing tasks associated with specific assignments, including collections, account follow up, billing, and allowance posting for the accounts assigned to you.

Key Responsibilities
  • Follow-up with Payers: Ensure timely resolution of all outstanding claims via phone, emails, fax, or websites.
  • Meet Daily Productivity/Quality Standards: Maintain daily productivity and quality standards established in departmental policies.
  • Use Workflow Systems: Utilize the workflow system, client host system, and other tools available to collect payments and resolve accounts.
  • Adhere to Policies and Procedures: Adhere to the policies and procedures established for the client/team.
  • Knowledge of Timely Filing Deadlines: Knowledge of timely filing deadlines for each designated payer.
  • Research Payer-Specific Billing Guidelines: Perform research regarding payer-specific billing guidelines as needed.
  • Analyze and Resolve Issues: Analyze, identify, and resolve issues causing payer payment delays.
  • Analyze and Trend Claims Issues: Analyze, identify, and trend claims issues to proactively reduce denials.
  • Communicate with Management: Communicate to management any issues and/or trends identified.
  • Initiate Appeals: Initiate appeals when necessary.
  • Identify and Correct Medical Billing Errors: Identify and correct medical billing errors.
  • Send Appeals and Supporting Documentation: Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete the recovery process.
  • Understand Under/Over Payments and Credit Balance Processes: Understanding of under or over payments and credit balance processes.
  • Assist with Special A/R Projects: Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required.
  • Act Cooperatively and Courteously: Act cooperatively and courteously with patients, visitors, co-workers, management, and clients.
  • Work Independently: Work independently from assigned work queues.
  • Maintain Confidentiality: Maintain confidentiality at all times.
  • Maintain a Professional Attitude: Maintain a professional attitude.
  • Other Duties: Other duties as assigned by the management team.
  • Protect Patient Information: Use, protect, and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
Requirements
  • Preferred Experience: Preferred 1-5 years' experience in insurance collections, including submitting and following up on claims for a medical practice, medical facility/medical billing company, ambulatory surgical center, and/or hospital or equivalent work experience.
  • Preferred Physician/Professional Billing: Preferred 1 year or equivalent work experience.
  • Basic Functioning Knowledge: Basic functioning knowledge of the denied claims and appeals process.
  • Basic Functioning Knowledge: Basic functioning knowledge of Worker's Comp and PIP preferred.
  • Basic Functioning Knowledge: Basic functioning knowledge of individual payor websites, including, but not limited to, Navinet, Availity, and the respective Blue Cross Blue Shield, Medicare, and Medicaid sites depending upon the state/s in which the client is located.
  • Knowledge of Medical Terminology: Knowledge of Medical Terminology, CPT Codes, Modifiers, and Diagnosis Codes.
  • Ability to Work Well: Ability to work well individually and in a team environment.
  • MS Office Basic Skills: MS Office basic skills. Must have basic Excel skillset.
  • Experience with Practice Management Systems: Experience with practice management systems. Preferably EPIC PB, Centricity, Allscripts, and/or Cerner.
  • Strong Communication Skills: Strong communication skills/oral and written.
  • Strong Organizational Skills: Strong organizational skills.
Working Conditions
  • Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals, and telephones; extend arms; kneel; talk, and hear.
  • Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
  • Work Environment: The noise level in the work environment is usually minimal.

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