Accounts Receivable Specialist

4 days ago

Rocky Hill, Connecticut, United States Summit Health Inc Full time
About Our Company

We're a physician-led, patient-centric network dedicated to simplifying healthcare and bringing a more connected kind of care. Our primary, multispecialty, and urgent care providers serve millions of patients in traditional practices, patients' homes, and virtually through our operating companies. When you're part of our team, you become part of a compassionate community of people who work hard every day to make healthcare better for all.

Job Description

This position plays a critical role in driving efficient, compliant, and effective claims and denials processing to optimize reimbursement for the organization. The responsibilities of this role include denied claims and A/R follow-up with various payers, including commercial insurances, Medicare, Medicaid, uninsured patients, workers' compensation, and other reimbursement categories.

Essential Functions/Responsibilities
  • Collect delinquent outstanding balances as quickly as possible by applying collection best practices as defined by our Standard Operating Procedures and training protocols.
  • Primary accountability for specific AR scope/function, such as commercial or uninsured or worker's compensation, etc.
  • Utilize various AR reports to target aged balances for collection in order to meet and maintain performance goals as set by management.
  • Evaluate denials and partial payments to determine if further reimbursement is valid.
  • Effectively participate in team meetings, payer discussions, and conference calls as needed.
  • Research and correct cash application of misapplied funds and payments on patient accounts as necessary.
  • Identify and request adjustments to insurance and patient accounts as necessary, while following departmental procedures and policies related to overpayments and credits and refunds.
  • Ability to consistently maintain productivity and quality expectations as defined by management.
  • Alert management to irregularities, insurance trends, and areas of concern with reimbursement.
  • Ability to maintain confidentiality of all information under HIPAA guidelines and policies and maintain PHI integrity.
  • Responsible for assisting in any new hire training within the AR Management team.
  • Responsible for assisting all new Rev Cycle cross-team members in the onboarding and training process.
  • Assists other departments within the Revenue Cycle department with various tasks/duties as assigned.
Qualifications
  • High School Diploma, GED, or Equivalent Required.
  • Atthem or UHC experience preferred.
  • Epic knowledge preferred.
  • Minimum of 2-4 successful years in a business collection environment preferred.
  • Prior medical billing and healthcare insurance knowledge.
  • Intermediate MS Word, Excel, Google (GMAIL, G Drive) necessary.
  • Solid understanding of state laws and insurance fee schedules and their impacts on billing and collection.
  • Excellent oral and written communication skills.
  • Excellent organizational and multitasking skills.
  • Flexible and approachable to colleagues and inter-departmental stakeholders.
  • Workers Compensation and No Fault prior billing experience a plus.
About Our Commitment

We highly value the critical role that health and wellness play in the lives of our team members and their families. Participation in our benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages, and a 401k savings plan.

We are an Equal Opportunity Employer and do not discriminate on the basis of race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression, national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.

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