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Accounts Receivable Specialist

Employer
PRIDE Health
Location
Parkville, MD
Closing date
Jan 25, 2021

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Our client, a healthcare organization based in the Baltimore area, is seeking an Accounts Receivable Specialist to join their team! RESPONSIBILITIES : Meets or exceeds expectations of individuals for whom service is provided. The Accounts Receivable Specialist is responsible for the follow up of 3rd party claims, correspondence, credits, and denials. The Accounts Receivable Specialist will maximize revenue by monitoring claims and remittances, filing appropriate appeals, and processing denied charges. This position requires a strong billing process, analyzing EOBs, and a comprehensive knowledge on all the nuances of each payer regulation according to company contracts and FQHC regulations. The position also requires a robust understanding of ICD10, HCPCS and CPT coding guidelines in order to identify trends, correct claims and resubmit for payment. The AR Specialist maintains strong working relationships with ancillaries and center staff in order to address any issues which will impact the processing of claims and/or our ability to ultimately collect for services rendered: and, maintains a positive working relationship with the payer representative to ensure problem resolution. The AR Specialist answers all billing calls from patients. Frequent communication outside of the work group is required to resolve disagreements, reach agreements and clarify issues/processes. Responsibility exists to ensure that internal customers are satisfied with service. Communication with external contacts involves handling complaints, making adjustments, corrections, etc. Review accounts and maintain accurate documentation Process AR timely focusing on unpaid claims in the appropriate buckets Resubmit corrected claims when necessary, and follow- up on all correspondence Ensure correct payments are being received, and submit appeals as needed Generate refunds and request refund letters on credits Contact insurance companies with any questions or issues Maintain good working relationships with provider representatives SKILLS AND QUALIFICATIONS: High school diploma or (GED). One year Medical Billing/Coding Certificate from college or technical school Required Certifications, Licenses, Registrations: None Three (3) Five (5) years experience in Accounts Receivable

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