Location: Indianapolis, IN, USOrganization: HHCSub-Division: HospitalSchedule: Full TimeShift: DaysFLSA StatusNon-ExemptJob Role SummaryThe Accounts Receivable Specialist is responsible for maintaining the life of a claim which includes the following: Claims Submission and Processing, Charge Entry, Claim Edit, DNB, Stop Bills, Claim Rejection, Denial Management, Accounts Receivable Follow-up, No Response, Compliance and Billing Regulations, Variance, Correspondence and Credit Balance Resolution. The Accounts Receivable Specialist communicates with the insurance carriers to ensure appropriate and compliant payment of services via telephone, email, fax, payor website. This position reviews reports to determine trends and discusses with management to help resolve front-end errors, reviews and follows up on all claims not paid by carriers in a timely manner and claims not paid appropriately.Essential Functions and ResponsibilitiesProactively contributes to Eskenazi Health's mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County. Models Eskenazi Health values of Professionalism, Respect, Innovation, Development and Excellence.Assist customer service with follows up on patient calls within a timely mannerMaintains department weekly production and monthly quality measuresCommunicates effectively and appropriately with internal and external customersActs independently seeking guidance when necessary to remain compliant with federal, state, and hospital policies relative to insurance patient billing.Initiates proper course of action for problem solving resolutionAnalyzes all claim denials to determine the best course of action to resolve any issue and receive appropriate paymentVerifies and updates claims with insurance and demographic information when changes are neededResolves inquiries from internal and external customersTakes active role in special projects as requestedGathers and distributes insurance information obtained through verbal and/or written communication for the purpose of maintaining sufficient cash flowAnalyzes and resolves issues reported from the self-pay outsource vendorUtilizes interpersonal communication strategies/skills to achieve desired outcome/results with patients/families and othersProvides coverage for co-workers as necessary due to PTO/illnessContinuing knowledge-based learning on payor guidelines and requirements for appropriate billingEnter daily charges for NTP clinicWorks charge review in a timely and accurate manner to ensure appropriate billing of servicesInvestigate and Resolves claim edits, rejections (internal/external), DNB, Stop Bills, follow up, variance, monitoring status of denials, denials, appeals, credit balance resolution and correspondence.Work queue management for better efficiency of work flows i.e. filters and rules.Follows up on unpaid claims with insurance companies.Initiate Billing/Charge Review resolutionJob RequirementsAssociate Degree in business-related field or technical training in coding and/or billing in lieu ofThree years of experience in medical practice/hospital setting with billing, insurance follow-up and/or credit balance experience.Dental, Vision, Behavioral Health and/or DME experience a plusKnowledge, Skills & AbilitiesPays close attention to detail with accuracy in record keeping and documentationIdentifies trends with denials (providers/locations/carriers) and works with management to help educate or resolve errors from the start and avoid back-end denialsWillingness and ability to assist other team membersExcellent problem-solving skills and ability to cooperate with othersWorks independently and efficientlyWorking knowledge of Microsoft Office Software, WindowsUtilizes calculator, printers, copiers, and fax machinesStrong organizational skills and ability to work efficiently in a high volume, multi-task environment meeting deadlinesUses professional and appropriate communication skillsAdvanced understanding of health insurance medical policy and billing requirements, including government and managed care programs as well as traditional Medicaid, Medicare replacement plans, commercial carriers, HIP, AnthemAbility to meet production and accuracy requirements outlined by department goals#J-18808-Ljbffr