Job Description
Job Requirements
Position Summary
- The AR management specialist works with unique department billing/collection functions to assure accounts are managed accurately and timely. Responsibilities will vary based on department need.
- Only Applicants from the following states: Alabama, Arizona, Connecticut, Delaware, Florida, Georgia, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, North Carolina, Pennsylvania, Rhode Island, South Carolina, Virginia, West Virginia, Wisconsin.
Minimum Requirements
- Education
- High School Diploma or equivalency
- Experience
- 4 years medical office or medical billing in a hospital or physicians billing setting, collections or coding experience.
- Must possess strong knowledge of CPT, HCPCS and ICD-9/10 codes.
- Must be efficient in reading insurance explanation of benefits (EOB) and understanding of remittance and remark codes.
- Good working knowledge of Microsoft Excel
- Good communication skills and the ability to interact well with multiple departments/levels of management
- License/Registration/Certifications
- N/A
Preferred Requirements
- Preferred Education
- N/A
- Preferred Experience
- In depth knowledge of all payer billing and eligibility requirements
- Preferred License/Registration/Certifications
- Certified Procedural Coder (CPC) (CPC-H)
- Certified Revenue Cycle Associate (CRCA)
- Certified Medical Insurance Specialist (CMIS)
- Registered Health Information Technician (RHIT)
- Core Job Responsibilities
- Responsible for research and resolution of all outstanding patient and insurance credit accounts, any additional A/R management research and account updates required to ensure claims are filed to the appropriate carrier or posted correctly.
- Processing of all refunds or credit reversals in a timely manner as defined within the departmental credit/refund policy/procedures.
- Responsible for all government monthly credit reporting preparation and requirements
- Responsible for accurate charge capture, charge review, claim edits, posting to the AR system and resolution of all charge edits.
- Responsible to handle all denials related to charge capture for improved integrity of charge capture
- Responsible to accurately update patient demographics, insurance registration information, verification of insurance, etc.
- Responsible for the consolidation of duplicate guarantor/patient accounts within the AR management system in an accurate/timely manner.
- Responsible for the review and processing of Accounts Receivables reports to ensure revenue integrity. Reporting trends identified during the analysis.
- Responsible to research and complete a detailed analysis of all payer variances based on our Contract modeling within our AR system.
- Revenue Management Specialist must have the skill set and understanding of payer and government payer contracts/schedules in order to confirm expected reimbursement amounts are correct.
- Work closely with other departments on revenue integrity issues including variance contract build issues, charging issues, A/R type issues and other items as define.
- Responsible for all account financial changes and refiling of those claims to the appropriate payer source.
- Assist with payer/physician credentialing and system table management.
- Responsible for electronic remittance, eligibility and claims agreements to insure the proper processing of electronic transactions, electronic remittance requirements and other payer requirements for billing.
- Responsible for the processing of all vendor claim updates, returns and resubmissions for payment.
- Other duties as assigned.
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