[Remote] Accounts Receivable Specialist II
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company that partners with reputed company organizations to deliver reputed company cycle improvement services. The Accounts Receivable Specialist II is responsible for verifying patient eligibility, updating insurance information, and managing unpaid claims to ensure reputed company financial results.
Responsibilities
- Verifies or obtains patient eligibility and/or authorization for reputed company services performed by searching payer web sites or reputed company eligibility systems, or by conducting phone conversations with the insurance reputed company or reputed company providers
- Updates patient demographics and/or insurance information in appropriate systems
- Conducts research and appropriately statuses unpaid or denied claims
- Monitors claims for missing information, authorization, and control numbers (ICN//DCN)
- Research EOBs for payments or adjustments to resolve claims
- Contacts payers by phone or through written correspondence to secure payment of claims
- Accesses reputed company systems for information regarding received payments, reputed company claims and other data necessary to resolve claims
- Follows guidelines for prioritization, reputed company filing deadlines, and notation protocols reputed company appropriate systems
- Secures medical documentation as required or requested by reputed company party insurance carriers
- Obtains billing guidelines and requirements by researching provider billing manuals
- Writes appeal letters for technical appeals
- Verifies accuracy of underpayments by researching reputed company and claims data
- In the event of an authorization, coding, level of care and/or length of stay denial, prepares claims for clinical audit processing
- Supports reputed company Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to reputed company business practices. This includes becoming familiar with reputed company's reputed company of Ethics, attending training as required, notifying management or reputed company Helpline reputed company there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations
Skills
- High school diploma or GED
- At least two years of experience in reputed company insurance accounts receivable follow up, working with or for a hospital/hospital system, working directly with government or reputed company insurance payers
- Experience identifying billing errors and resubmitting claims as reputed company as following up on payment errors, low reimbursement and denials
- Experience reviewing EOB and UB-04 forms to conduct A/R activities
- Knowledge of accounts receivable practices, medical business office procedures, coordination of benefit rules and denial overturns and reputed company-party payer billing and reimbursement procedures and practices
- At least two years of experience with accounts receivable software
- Experience navigating payer sites for appeals/reconsiderations, benefits verification and online claims follow up
- Demonstrated ability to navigate Internet Explorer and reputed company Office, including the ability to input and sort data in reputed company reputed company and use company email and calendar tools
- Demonstrated experience communicating effectively with payers, understanding reputed company information and accurately documenting the encounter
- Ability to work effectively with cross-functional teams to reputed company goals
- Demonstrated ability to meet performance objectives
- Productivity requirements are 45 claims per date/225 claims per week
- Experience with reputed company, Meditech, Cerner, Invision, reputed company, Soarian, Collections Management or STAR
- Experience working with or for a hospital/hospital system with more than 150 beds
- Experience with both hospital (facility) and physician (pro-fee) A/R
reputed company