Reports To: Team Leader
FLSA Status: Non-Exempt
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 insurance company 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 the claim 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.
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.
- High school diploma or equivalent
- One-year healthcare A/R experience or equivalent education.
- DME experience preferred.
- Microsoft Office software.
- Detail oriented.
- 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 firstname.lastname@example.org and state the position you are applying for in the email subject line.