Accounts Receivable Specialist 1

Essential Duties & Responsibilities: 

• Verify/obtain  eligibility and/or authorization utilizing payer web sites, client eligibility systems or via phone with the insurance carrier/providers 

• Update patient demographics/insurance information in appropriate systems -  

• Research/ Status unpaid or denied claims  

• Monitor claims for missing information, authorization and control numbers(ICN//DCN)  

• Research EOBs for payments or adjustments to resolve claim 

• Contacts payers via phone or written correspondence to secure payment of claims 

• Access client systems for payment, patient, claim and data info 

• Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems 

• Secure needed medical documentation required or requested by third party insurance carriers  

• Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure 

• Perform other related duties as required 

Minimum Requirements & Competencies:  

• 1-2 years of medical collections/billing experience 

• Basic knowledge of ICD-10, CPT, HCPCS and NCCI 

• Basic knowledge of third party billing guidelines 

• Basic knowledge of billing claim forms(UB04/1500) 

• Basic knowledge of payor contracts 

• Working Knowledge of Microsoft Word and Excel 

• Basic working knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.) 

Preferred Requirements & Competencies:  

• Working knowledge of one or more of the following Patient accounting systems -  EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon 

• Working knowledge of DDE Medicare claim system 

• Knowledge of government rules and regulations