Accounts Receivable Specialist

Summary : At the direction of the Assistant Revenue Cycle Manager – Accounts Receivable, responsible for the follow-up on unpaid primary and secondary claims, claim denials, underpaid and overpaid claims in accordance with established guidelines.

Education: High school diploma or equivalent

Experience: One (1) year experience in medical billing or equivalent experience or externship.

Essential Job Functions:

• Execute follow-up on claims per Medac and carrier protocols
• Maintain production of at least 45 claims daily for Anesthesia claims, 40 claims per day for Pain claims
• Maintain accuracy of follow-up at 95% per audit guidelines
• Seek first-time resolution on each claim
• Identify root cause of claim denials and underpayments; process appeals in accordance with carrier policies
• Identify denial, underpayment, or other unpaid claim trends or patterns; report such trends and patterns to the Assistant Revenue Cycle Manager.
• Perform balance and pending patient transfers and other related tasks
•  Perform customer contact as over flow from the Patient Service Center
•  Maintain accounting of daily activities
•  Document notes in the billing system in accordance with protocols; ensure adequate detail and clarity of notes
•  Other duties as assigned

Performance Requirements:

• Knowledge
• Understanding of medical billing
• Knowledge of billing practices and procedures; knowledge of carrier reimbursement policies and appeal procedures
• Knowledge of HIPAA (legal and ethical consideration related to patient information)

Skills:

•  Excellent communication, organization, and time management skills
•  Proficient skills in computer programs; KAM billing system, Word and Excel
•  Flexibility – willingness to help in other accounts and other areas as needed
•  Assertiveness – recognize problems, suggesting solutions and overall improvement of the service to Medac Inc.’s clients
•  Detail oriented

Abilities

•  Ability to meet minimum production and accuracy standards
•  Ability to follow instructions and written guidelines in account specifics
•  Ability to understand and interpret policies and regulations
•  Ability to examine documents for accuracy and completeness
•  Ability to schedule time and assignments effectively
•  Dependability – arrive at work on time, work overtime when necessary to fulfill requirements of position, and complete work as directed
•  Attitude – be a team player with a willingness to cooperate and grow in experience

Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephone,calculators, etc.

Work Environment: Position is in a well-lighted office environment.

Mental/Physical Requirements: Involves sitting approximately ninety (90) percent of the day, walking or standing the remainder. Attention to detail may add stress to conditions.

Job Type: Full-time

Required education:

• High school or equivalent

Required experience:

• medical billing: 2 years