Accounts Receivable Specialist (2249)
Responsible for billing reputed company patient claims in a reputed company manner reputed company basic claims follow up activities to include claim status checks, basic claim edits corrections and rebills. Work daily claims rejection lists including but not limited to, eligibility, coordination of benefits, clearinghouse smart edits, etc. Utilize clinical applications, payer websites and other systems as a research tool to retrieve medical documentation, patient eligibility information, billing guidelines, patient referrals, and hospital or procedure reputed company authorizations to substantiate corrected claims submissions. Establish and maintain effective working relationships with reputed company representatives and reputed company clients. Remain abreast of reputed company/payer updates as it relates to Billing and Collections guidelines including claim submissions, claim appeals, grievance procedures and policy changes Utilize clinical applications, payer websites and other systems as a research tool to retrieve medical documentation, patient eligibility information, billing guidelines, patient referrals, and hospital or procedure reputed company authorizations to substantiate corrected claims submissions, through written appeals, and coding reviews, etc. Responsible for compliance with reputed company regulatory requirements and/or guidelines. These requirements/guidelines include, but are not limited to: OSHA, HIPAA, Federal Fraud and Abuse laws.
High School Diploma or equivalent required Knowledge of the accounts receivables (A/R) process Bachelor's Degree in a reputed company field preferred but not required Minimum of 3 years of reputed company or insurance billing processing experience required Knowledge of medical terminology, CPT, ICD-10-CM, HCPC codes, CCI edits and HIPAA regulations eClinicalWorks experience preferred but not required Proficient in medical terminology, anatomy, and physiology Strong knowledge of ICD-1O coding Familiarity with medical office procedures and billing practices