Accounts Receivable Specialist
3 days ago
We are seeking a highly skilled Accounts Receivable Specialist to join our team. The successful candidate will be responsible for resolving patient account balances associated with insurance denials, answering incoming insurance and practice calls, and working with practices and payers to resolve claim denials and comply with insurance and Steward Health Care procedures, guidelines, and policies.
Key Responsibilities- Resolving patient account balances associated with insurance denials
- Answering incoming insurance and practice calls
- Working with practices and payers to resolve claim denials and comply with insurance and Steward Health Care procedures, guidelines, and policies
- Monitoring insurance denials by running reports and contacting insurance companies to resolve and recover denied claims
- Monitoring aging reports for timely follow-up on unpaid claims
- Knowledge of payer authorization guidelines in an effort to determine if appeal requires a clinical review or can be handled from a technical perspective
- Retroactive review of registration data to aid in the assurance of clean claim submittal
- Accurately documenting claim actions taken within patient account/claims
- Ability to navigate and toggle back and forth within multiple payer websites and internal billing systems to determine various aspects of account detail necessary for data management
- Serving as a resource for problem-solving issues related to registration, demographic, and insurance errors
- Working payer correspondence including support tickets, emails, and phone messages from internal and external contacts
- Working collaboratively with Coding, Provider Enrollment, and Cash Posting team as well as coworkers, Team Leads, Managers, and practice staff to resolve claim and account issues
- Customer/Patient Account Services Skills
- Ability to drive results while balancing multiple priorities and tasks
- Ability to keyboard at 35 words per minute
- Ability to diagnose and troubleshoot problems, ability to perform mathematical calculations
- Knowledge of ICD-9 and CPT-4 coding
- Strong knowledge of third-party payor guidelines and procedures, particularly medical terminology
- Strong verbal and written communication skills
- Strong analytical skills and computer skills, including Outlook, Excel, and Word
- Associates Degree in Business, Accounting, or Finance preferred
- 1-3 years experience and/or knowledge of insurance denials process, health care claims processing, and follow-up background
- 1-3 years billing experience and insurance knowledge (eligibility, registration, etc.)
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