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Accounts Receivable Specialist

2 months ago


Houston, Texas, United States Medical AR Management Services, LLC Full time
Job Overview

Position: Accounts Receivable Collections Specialist

Work Environment: Onsite

The Accounts Receivable Collections Specialist plays a crucial role in upholding industry benchmarks for designated accounts receivable, including aging reports, collection efficiency, appeals, denials, and claims with no activity. This position involves posting necessary adjustments and diligently following up on all pending insurance claims. The specialist will utilize aging reports as instructed by the Accounts Receivable Manager to reduce accounts over 90 days to acceptable levels. Consistent communication with both internal and external stakeholders, as well as third-party payers, is vital. This role is committed to adhering to all established policies and procedures.

Key Responsibilities:

  • Investigate and refile or appeal claims as required
  • Track rejects and denials to identify discrepancies
  • Conduct daily follow-ups on outstanding insurance claims
  • Post necessary adjustments and manage deductible transfers
  • Assist in the resubmission of claims
  • Enhance billing processes in collaboration with supervisors
  • Resolve issues related to unpaid claims and discrepancies
  • Prepare documentation for claim resubmissions
  • Manage correspondence from insurance providers
  • Review and rectify account discrepancies
  • Perform additional related tasks as assigned

Qualifications:

  • Minimum of 3 years' experience in healthcare collections
  • Familiarity with Medicare, Medicaid, and commercial insurance collections
  • Strong ability to interpret Explanation of Benefits (EOBs)
  • Excellent cognitive skills, attention to detail, and decision-making capabilities
  • Strong collaborative and organizational skills
  • Ability to manage multiple tasks simultaneously
  • Effective verbal and written communication skills
  • Proficient in Microsoft Office, particularly Excel
  • Understanding of privacy regulations

Education and Experience:

  • High School diploma or equivalent
  • ACPC certification preferred but not mandatory