Department: Reimbursement
Reports To: Team Leader
FLSA Status: Non-Exempt

Position Summary:
The A/R Specialist has responsibilities in the following aspects of A/R: Collect correct payment on insurance A/R by submitting corrected claims, appealing or facilitating the reprocessing of denied, low-paid or unprocessed claims; collect on private pay accounts through outbound/inbound calls and correspondence; meet collection, productivity and quality goals as set forth by leadership.

Responsibilities and Duties:

  • Insurance Collections
  • Verify correct filing and resubmit claims that have not been processed by insurancecompany timely.
  • Contact patient, physician office, and internal resources to obtain information and documentation to facilitate collection of claims.
  • Work insurance denials to correct unclean claims or notify payer of incorrect processing.
  • Follow up on outstanding A/R that has not been processed for full payment until theclaim is resolved.
  • Utilize collections expertise to identify and escalate payer issues.
  • Write appeals to insurance companies to overturn denied or short paid claims.
  • Private Pay Collections
  • Apply a systematic approach in collecting past due balances from customers.
  • Makes collection phone calls on past due accounts.
  • Review patient pay accounts receivables aging and determine areas that need further review.
  • Manage relations with credit reporting and collection agencies.
  • Utilize automated collections tools such as dunning letters to facilitate private pay collections.
  • Respond to customer calls or written inquires immediately.
  • Resolve patient account issues as needed.
  • Maintain professional communication with other departments as appropriate.
  • Performs other duties as assigned by leadership.

Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Education:

  • High school diploma or equivalent

Experience/Knowledge:

  • One-year healthcare A/R experience or equivalent education.
  • DME experience preferred.
  • Microsoft Office software.
  • Detail oriented.

Physical Requirement:

  • May occasionally lift or move up to 30 pounds.
  • Ability to reach, bend, carry, hear, read and write.
  • Manual dexterity with fine hand coordination.

To apply, please send your resume to hr@chcsolutions.com and state the position you are applying for in the email subject line.