Accounts Receivable Specialist

Overview: The A/R Specialist is responsible for the company’s third-party medical claims processing and assisting patients and office staff with questions on insurance claims, authorizations, statements, and other billing issues. This position will submit and follow-up on medical claims for Managed Care Organization (MCO), Medicaid, Medicare, Other Federal, Private Insurance, and Workers Compensation.

Duties and Responsibilities:

• Work unpaid claims in follow-up work queues.

• Rebills/appeals claims within 30-45 days of denial date.

• Provide insurance companies with needed medical records or documents when requested.

• Identifies payer trends or issues and reports to leadership for resolution. 

• Bill patients for non-covered services.

• Bill secondary and tertiary insurances after primary payment.

• Assist patients with self-pay balances.

• Always maintain proper work standards in productivity and quality.

• Other tasks as assigned by the Director, Revenue Cycle and Billing.

Education, Experience, Licensure/Certification and Skills/Abilities Related Requirements:

• High School Diploma required. 

• 2 years billing experience

• 5 years collection experience

• FQHC collection experience preferred

Continuing Education and Training Requirements:

Participates in trainings required by the funding source and/or as required by licensure.