Accounts Receivable Specialist

Job Description

POSITION SUMMARY
The Accounts Receivable Specialist is responsible for researching, identifying and rectifying any circumstances affecting delayed or non-payment of patient insurance claims. Processes paper claims for assigned accounts and sends these claims to the appropriate insurer in order to collect payment on balances owed to the organization. Insures that clean and correct claims are sent to the insurers, including appropriate back up documentation when required. Prepares and submits coverage and payment appeals to insurances when appropriate. Resolves credit balances due to overpayments within time guidelines. Maintains up-to-date knowledge of payer requirements. Responds to patient or guarantor inquiries and/or concerns and assists in resolving their obligations. Must be able to work independently and be self- directed. Must have the ability to work well under pressure and to adapt positively to change, work cooperatively with staff members, clients and management in a professional and positive manner to ensure quality service. Will actively contribute to the teamwork approach. Performs other duties as directed. Responsible for personal and corporate compliance with local, state, and federal regulations. Adheres to corporate and departmental policy and procedure.
BASIC KNOWLEDGE
Two years of college, Associates degree, or equivalent relevant experience may be required. Must be familiar with and able to operate a calculator, fax, and other general office equipment. Proficiency in personal and mainframe computers required. Excellent self-management, time management, analytical and problem solving, math, organizational, and communication skills required, including business writing skills. Must be a team player. Must be able to understand and apply State, Federal, and commercial insurance guidelines, and apply these to hospital policies and daily work.
EXPERIENCE
Two or more years in a healthcare setting or medical claims processing experience is helpful.
Additional experience may be required.