Medical Accounts Receivable Specialist

2 weeks ago

Murfreesboro, Tennessee, United States Winston Staffing Services Full time
Job Title: Medical Accounts Receivable Specialist

Winston Staffing Services is seeking a highly skilled Medical Accounts Receivable Specialist to join our team. As a Medical Accounts Receivable 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:

  1. Follow up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax, or websites.
  2. Meet and maintain daily productivity/quality standards established in departmental policies.
  3. Use the workflow system, client host system, and other tools available to collect payments and resolve accounts.
  4. Adhere to the policies and procedures established for the client/team.
  5. Knowledge of timely filing deadlines for each designated payer.
  6. Perform research regarding payer-specific billing guidelines as needed.
  7. Analyze, identify, and resolve issues causing payer payment delays.
  8. Analyze, identify, and trend claims issues to proactively reduce denials.
  9. Communicate to management any issues and/or trends identified.
  10. Initiate appeals when necessary.
  11. Ability to identify and correct medical billing errors.
  12. Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete the recovery process.
  13. Understanding of under or over payments and credit balance processes.
  14. Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required.
  15. Act cooperatively and courteously with patients, visitors, co-workers, management, and clients.
  16. Work independently from assigned work queues.
  17. Maintain confidentiality at all times.
  18. Maintain a professional attitude.
  19. Other duties as assigned by the management team.
  20. Use, protect, and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

Qualifications:

  1. Preferred 1+ 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.
  2. Preferred Physician/Professional Billing: 1 year or equivalent work experience.
  3. Basic functioning knowledge of the denied claims and appeals process.
  4. Basic functioning knowledge of Worker's Comp and PIP preferred.
  5. 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.
  6. Knowledge of Medical Terminology, CPT Codes, Modifiers, and Diagnosis Codes.
  7. Ability to work well individually and in a team environment.
  8. MS Office basic skills. Must have basic Excel skillset.
  9. Experience with practice management systems. Preferably EPIC PB, Centricity, Allscripts, and/or Cerner.
  10. Strong communication skills/oral and written.
  11. Strong organizational skills.

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