Accounts Receivable Specialist

Expiring today

Ventra Health, Inc.
Frederick, MD
Jul 29, 2022
Aug 08, 2022
Full Time
Overview: Job Summary: Accounts Receivable ("AR") Specialists are primarily responsible for analyzing collections, resolving non-payables, and handling bill inquiries for more complex issues. AR Representatives are responsible for insurance payer follow-up ensuring claims are paid according to client contracts. Complies with all applicable laws regarding billing standards. Responsibilities: Essential Functions and Tasks: Follows up on claim rejections and denials to ensure appropriate reimbursement for our clientsProcess assigned AR work lists provided by the manager in a timely mannerWrite appeals using established guidelines to resolve claim denials with a goal of one contact resolutionIdentified and resolved denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizationsRecommend accounts to be written off on Adjustment RequestReports address and/or filing rule changes to the managerCheck system for missing paymentsProperly notates patient accountsReview each piece of correspondence to determine specific problemsResearch patient accountsReviews accounts and to determine appropriate follow-up actions (adjustments, letters, phone insurance, etc.)Processes and follows up on appeals. Files appeals on claim denialsScan correspondence and index to the proper accountInbound/outbound calls may be required for follow up on accountsRoute client calls to the appropriate RCMRespond to insurance company claim inquiriesCommunicates with insurance companies for status on outstanding claimsMeet established production and quality standards as set by Ventra HealthPerforms special projects and other duties as assigned Qualifications: Education and Experience Requirements: High School Diploma or GEDAt least one (1) year in data entry field and one (1) year in medical billing and claims resolution preferredAAHAM and/or HFMA certification preferredExperience with offshore engagement and collaboration desiredKnowledge, Skills, and Abilities (KSAs): Intermediate level knowledge of medical billing rules, such as coordination of benefits, modifiers, Medicare, and Medicaid and understanding of EOBsBecome proficient in use of billing software within 4 weeks and maintain proficiencyAbility to read, understand, and apply state/federal laws, regulations, and policiesAbility to communicate with diverse personalities in a tactful, mature, and professional mannerAbility to remain flexible and work within a collaborative and fast paced environmentBasic use of computer, telephone, internet, copier, fax, and scannerBasic touch 10 key skillsBasic Math skills Understand and comply with company policies and proceduresStrong oral, written, and interpersonal communication skillsStrong time management and organizational skillsStrong knowledge of Outlook, Word, Excel (pivot tables), and database software skills

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