Accounts Receivable Specialist

2 weeks ago

Catonsville, Maryland, United States TEKsystems Full time
Job Description

TEKsystems is seeking skilled Medical Accounts Receivable Specialists in the healthcare sector.

Essential Qualifications:

Required: Previous experience in medical billing is mandatory.

Role Overview:

The Accounts Receivable Specialist is responsible for conducting thorough research, making necessary corrections, and updating information within the accounts receivable management systems to ensure proper billing and collection of payments for services rendered in resident care. Key responsibilities include:

  • Accurate pre-billing reviews, billing processes, follow-ups, and cash postings within designated areas.
  • Reviewing admissions and census data.
  • Validating claims through a meticulous triple-check process.
  • Managing billing across various business lines.
  • Following up on third-party and private pay accounts.
  • Posting cash and addressing denials.
  • Resolving credit balances and processing refunds.
  • Finalizing resident billing.
  • Providing customer service through an A/R help desk.
  • Executing month-end closing procedures.

The role also involves translating internal charge files into appropriate billing formats for both electronic and manual claims submissions to third-party and private payers. Specialists will perform follow-ups and collections on accounts with outstanding balances, adhering to departmental guidelines for account documentation to ensure clarity for all stakeholders involved in accounts receivable management.

Additionally, the role requires initiating appeals, submitting corrected claims, or providing medical records in response to payer inquiries or denied claims. Responsibilities include:

  • Posting contractual allowances, write-offs, and payments against relevant claims using the Explanation of Benefits (EOB) or Remittance Advice.
  • Documenting rejection and denial transaction codes with appropriate descriptions.
  • Investigating misapplied cash and credit balances using correct payment and write-off codes.

Additional Skills & Qualifications:

Candidates should possess at least one of the following:

  • A minimum of two (2) years of experience in healthcare accounts receivable, including billing, collections, or cash posting.
  • Graduation from an accredited two-year college with a focus on Accounting, Finance, Business Administration, Healthcare Finance/Administration, or a related field is preferred.
  • Current Certified Revenue Cycle Specialist (CRCS-I) certification from the American Association of Healthcare Administrative Management (AAHAM) is advantageous.

Proficiency in billing, collections, and cash posting processes within a healthcare provider environment is essential. Experience with Medicare, Medicaid, and Managed Care is a plus. Familiarity with CPT and ICD-10 coding, medical terminology, and federal, state, and third-party electronic claims submission practices is also beneficial. Experience with CMS1500 and UB04 claim forms, as well as knowledge of medical practice management systems, is required. Proficiency in Microsoft Office, particularly Excel, Word, and Outlook, is necessary. A High School Diploma or equivalent is required.

About TEKsystems:

TEKsystems is a leader in Full-Stack Technology Services and Talent Services, partnering with clients to harness innovative ideas and solutions in a rapidly evolving landscape. With a workforce of 80,000 and collaborations with over 6,000 clients, including a significant portion of the Fortune 500, we are committed to driving transformation and delivering impactful results. TEKsystems is part of the Allegis Group and is an equal opportunity employer, welcoming applications from all individuals without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law.

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