AR/Denials Specialist

<p><strong>Summary Description:</strong></p><p><br></p><p>Under general direction, this position objective is to assist the Client Services Manager with the clients accounts in collections and billing. Accounts Receivable Specialist to present data to appropriate parties and partnering with Client Services Manager to develop resolutions and are responsible for providing timely and efficient follow-up with all payer types for all unpaid claims, consistent with the Company mission and goals.</p><p><br></p><p><strong>Daily Responsibilities</strong></p><p><br></p><p>● Research and re-bill unpaid claims.</p><p>● Responsible for verifying insurance benefits or payment source on all patients.</p><p>● Responsible for set up of patient financial files.</p><p>● Responsible for accurate computer data input on all patients, notes, and claims.</p><p>● Generates invoices for insurance billing, individual account billing, and follow-up billing for deductibles and copays.</p><p>● Researches denied or pending claims and provides additional information to facilitate claim payment.</p><p>● Negotiates with the responsible party on accounts more than sixty days past due.

When unable to secure an agreement satisfactory to both parties, submits these accounts to the Client Services Manager for review prior to turning to private collection.</p><p>● Responsible for collection of patient information and verification of reimbursement source. Maintains patient financial files. Generates billing invoices and is responsible for collections.</p><p>● Required to maintain confidentiality at all times.</p><p>● Research and resolve accounts appearing on Follow-up Reports.</p><p>● Make appropriate decisions and calls to carriers to maximize reimbursement on accounts to be worked.</p><p>● Correct all errors on electronic error reports using all the available information.</p><p>● Meet production and quality standards.</p><p>● Assists in identifying current and/or potential billing issues specific to outstanding receivable</p><p>● Participates in daily production assignments that will continue to develop an understanding and knowledge of processing guidelines and expectations of respective client(s) payer mix.</p><p>● Ability to take patient phone calls and assist Customer Service when business needs arise.</p><p>● Answer multi line phone.</p><p>● Assist in other duties as assigned.</p><p><br></p><p><strong>Skills and

Education:

</strong></p><p><br></p><p>● 2 + years of relevant healthcare AR experience and / or customer service</p><p>● Experience working with claims billing and denials preferable</p><p>● Seeks continual professional development by updating current knowledge base regarding private insurance reimbursements.</p><p>● Participates in staff meetings and offers appropriate and constructive suggestions and criticism.</p><p>● Utilizes any extra time during decreased workload to assist other employees that may have extra workloads.</p><p>● Organizes work in a manner to keep up with all the details of the job requirements.</p><p>● Demonstrates competency in skills and knowledge pertinent to the practice of accounts receivable.</p><p>● Demonstrates working knowledge of Insurance Company rules and regulations as pertaining to reimbursements for services rendered by Preferred.</p><p>● Consistently performs routine tasks in an independent manner, while exercising good judgment during those instances when help may be needed, or a supervisor needs to be informed.</p><p>● Utilizes proper chain of command when addressing concerns or problems.</p><p>● Proficient computer skills with Microsoft Office: Excel, Word and Outlook</p><p>● Knowledge of ECW, Centricity, and/or Epic preferred</p><p>● Excellent Communication (Verbal & Written) Skills</p><p>● Data entry skills</p><p>● Strong work ethics and confidentiality</p><p>● Time management skills and attention to detail</p><p>● High school diploma or equivalent</p><p><br></p><p><strong>Other Duties</strong><br>Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job.

Duties, responsibilities and activities may change at any time with or without notice.</p>