Accounts Receivable Specialist Clients- Medical Pract HCS

Facility:      Administrative Regional Training Cntr

Shift: Shift 1

Status:     Full Time      FTE: 1.066667

Bargaining Unit:     Catholic Health Emmaus

Exempt from Overtime:     Exempt: No

Work Schedule:  Days

Hours:         

Flexible between 7am - 5pm

Summary:

The position will support the clients and Medical Practices of HCSWNY, and responsibilities will include, but are not limited to, the following

• Ensures that clients are reimbursed properly and efficiently by verifying patient insurance information, reviewing billing information, verify accuracy of charges. Performs follow-up on insurance company denials on a timely basis
• Review of all claims for accuracy
• Review and identify errors or issues with billing and correct the issue for billing
• Review and correct all response files from electronic submissions
• Document all patient accounts with each action taken into appropriate system.
• Follow up on all daily correspondence received on a timely basis.
• Responsible to keep up to date with current insurance billing requirements and changes by reading payer newsletters and other publications.
• Follow up on any unpaid/outstanding/denied claims within the payers timely filing guidelines to ensure proper receipt of the claim by the insurance company or State/Federal agency, including:

1. Verify patient’s insurance information using Hnet, ePaces, Connex, insurance company portals, phone calls and/or letters to patients and/or insurance carriers and/or their websites.
2. Make appropriate changes to correct the denied claims and submit corrected electronic or paper claims to the appropriate insurance carrier.
3. Reviews EOB’s for denial or partial payment information.
4. Interacts with insurance companies to resolve issues delaying the collections of accounts, including the use of phone calls, emails, and portals.

• Performs other related duties as requested.

Responsibilities:

Education Requirements

• High School diploma
• Graduate of a certificate program for Medical Billing Program preferred

Experience Requirements

• Two years of Medical Billing experience preferred
• Certification in Medical Billing/Reimbursement is a plus

Knowledge, Skill and Ability

• Demonstrates knowledge of third party billing procedures
• Knowledge of claims review and process
• Strong computer skills (MS Word and Excel preferred)
• Excellent written and oral communication skills
• Excellent organizational skills
• Ability to work well with others
• Dependable in both production and attendance
• Self-Motivated

WORKING CONDITIONS

Environment

• Normal heat, light space, and safe working environment; typical of most office jobs