Accounts Receivable Specialist FT

4 days ago


West Columbia, South Carolina, United States Doctors CareUCI Medical Affiliates, Inc. Full time

Position Title: Accounts Receivable Specialist

Specialty: Credit Balance (Experienced Professional)
Location: Columbia, South Carolina
Full Time/Part Time: Full Time

Company Overview:
UCI Medical Affiliates, Inc. (UCI) provides non-medical management and administrative services to over 50 Doctors Care urgent care centers and 24 Progressive Physical Therapy facilities located throughout South Carolina. UCI is headquartered in Columbia, South Carolina. Doctors Care has operated for over 30 years, providing an exceptional, convenient, and affordable healthcare experience.

Job Summary:
We are seeking an experienced Accounts Receivable Specialist to join our team. The successful candidate will be responsible for resolving outstanding, unpaid, unprocessed, and denied claims submitted to third-party payers on behalf of Progressive Physical Therapy providers. This includes accessing third-party websites, placing outbound phone calls, accepting inbound phone calls, sending and receiving facsimiles, and sending and receiving correspondence with third-party payers and various government agencies for follow-up on non-responsive claims and denials for payments.

Key Responsibilities:

  • Apply knowledge related to interpreting explanation of benefits and regulations concerning coordination of benefits and other applicable guidelines. This includes being able to assess that reimbursement, allowances, and patient payments received are applied correctly.
  • Resolve accounts by various methods, including making adjustments, transferring funds, corresponding with necessary contacts, responding to inquiries, utilizing various tools for addressing discrepancies and initiating recoupment requests, and processing refunds, all in accordance and in compliance with company, state and federal policies, regulations and procedures.
  • Make corrections on credit balance accounts as necessary.
  • Follow up on self-pay/patient refunds as needed.
  • Monitor, manage and resolve unapplied and unassigned payments/credits in the patient credit workbaskets.
  • Review, research and resolve insurance claims, unprocessed third party claims, denials, underpayments and overpayments.
  • Verify accuracy of billing data and correct errors; resubmit clean claims to payers electronically or via paper claim.
  • Work, monitor and manage his/her respective workbaskets including, but not limited to, denials, 60 Day, 90 Day, 120 Day, and 150 Day aging on assigned insurance carrier(s) to get claims paid in a timely manner.
  • Work incoming mail and EOBs (Explanation of Benefits) from the insurance carriers and process claims related correspondence to resolve issues.
  • Work EDI transactions, ERA files and rejection reports.
  • Contact payers via phone to help expedite the resolution of claims and payments.
  • Access web-based applications and internet for claim status and eligibility of services.
  • Identify and resolve patient billing complaints and inquires. Assist the overflow customer service line when volume of incoming calls warrants assistance.
  • Comply with Patient Accounting quality and productivity standards.
  • Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations.
  • Other duties and responsibilities as assigned by supervisor.
Requirements:
  • High School diploma or equivalent
  • Three (3) years medical billing experience
  • Strong knowledge of Medicare claims processing regulations and other payer specific guidelines
  • Strong written and verbal communication skills
  • Ability to establish and maintain cooperative working relationships and the ability to work in teams
  • Proficiency in Microsoft Office programs such as Word, Excel and Outlook
Preferred Qualifications:
  • Associates Degree
  • Medical Billing, Revenue Cycle and/or Coding Certification (CRCR, CPC)
What We Offer:
  • Competitive wages
  • Generous PTO that increases with tenure
  • 401K
  • Health, dental, vision insurance
  • Flexible Spending Account
  • Short term and Long term Disability
  • Whole and Term Life Insurance
  • Employee Discounts
  • Rewarding Careers


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