AR Specialist

Accounts Receivable Specialist

Primarily responsible for accurately posting payments and providing billing and accounts receivable support to ensure timely and accurate reimbursement. This role may include charge entry, payment posting, customer service and follow-up in accordance with practice protocol with an emphasis on maximizing patient satisfaction and profitability. This is an integral role in supporting the revenue cycle.

Payment Posting

• Accurately post payments and adjustments into the practice management system including co-payments, insurance payments, and patient payments in accordance
• Reconcile posted payments (unapplied) with deposits and billing guidelines
• Identify over and underpayments, denials
• Apply contractual adjustments in accordance with payer agreements and alert leadership of any discrepancies
• Ensure all payment batches are balanced in both their dollar value of payments and adjustments prior to posting
• Maintain up to date account records to ensure accuracy and patient satisfaction
• Post all credit and debit adjustments to patient accounts
• File all charge, payment and adjustment batches in the appropriate format by batch date for quick reference

Accounts Receivable

• Provide customer service via telephone and/or email for all patients and authorized representatives regarding patient accounts in accordance with practice protocol
• Assist with patient calls regarding AR inquiries and/or processing payments
• Verify all demographic and insurance information in the electronic health record for accuracy prior to resubmitting or processing a claim
• Follow-up on assigned outstanding insurance claims
• Provide new or relevant or trending information as it pertains to claims, insurance coverage guidelines, compliance, and/or reimbursement to leadership to educate the team
• Recommend accounts and assist with initial review for outside collection agency when internal collection efforts fail in accordance with practice protocol
• Work closely with the revenue cycle team members to resolve account discrepancies

Back Up Billing

• Serve as back up to Billing during absences and high-volume periods
• Submit clean claims to insurance carriers and other payers in a timely manner
• Review claims for accuracy, apply appropriate modifiers, and follow checklist for consistency
• Correct and resubmit rejected or denied claims as necessary
• Submit to secondary insurance as appropriate

Other

• Attendance at relevant seminars to remain abreast of current issues regarding Orthotics and Prosthetics accounts receivable
• Ensure compliance with company, local, state, and federal regulations including but not limited to Fraud & Abuse, Medicare Compliance, HIPAA, OSHA, etc.
• Proficiency with all facets of the medical practice management system including patient registration, charge entry, insurance processing, advanced collections
• Proficiency with insurance portals for eligibility verification and claim status, med rec submissions, appeals, etc to efficiently conduct accounts receivable follow-up and to maximize revenue.
• Maintain an organized, efficient and professional work environment.

Required Skills

· Strong communications skills (Verbal and written)

· Solid mathematical skills

· Requires a minimum typing speed of forty (40) words per minute and ten-key by touch.

· Extensive working knowledge of managed care networks and insurance carriers

· Familiarity with EOBs, ERAs, and medical billing processes

· Extensive knowledge of accounts receivable functions including HCPCS and ICD-10 coding

· Proficiency in general office automation including operation of e-fax, postage machines, and multi-line phone systems, computers, scanners, portals, etc

· Proficiency in working with a PC, the Internet, and MS Windows

· Ability to prioritize, plan, and organize daily responsibilities

· Critical thinking and problem-solving abilities

· Team oriented with the ability to be self-driven and independent

Education & Experience

· High School Diploma

· At least 3 to 5 years’ experience in healthcare accounts receivable