Job Description

Job Title: Medical Accounts Receivable Specialist FLSA/Status: Hourly

Reports To: Senior Revenue Cycle Manager Location: Hybrid

Department: Billing Travel Required: No

Supervisory Responsibility: No

Position Summary:

The Medical Accounts Receivable Specialist is responsible for demonstrating knowledge and application

of job duties within scope of practice and functions under the direction of the manager(s) and/or

Director(s); respectfully interacts with all levels of staff; provides assistance, as needed, during assigned

duty hours; participates in department activities; promotes independence; adherence to the attendance

policy; encourages socialization; advocates for the quality of life of our patients while maintaining

compliance with all applicable laws, regulatory and organizational standards; supports the company’s

core values.

Summary of Duties and Responsibilities:

? Understands and has experience with multiple carrier types (Medicare, Medicaid, Dual,

? Commercial, Managed Care and Advantage plans) in multiple states.

? Research and investigate denied or no response claims to confirm reason for denial and best

? method of recovery.

? Reviews payer policies and guidelines to support reconsiderations and appeals where needed.

? Identifies trends and notifies leads and manager immediately to establish plan of action.

? Submits corrected claims, reconsiderations and appeals via portal, fax or secure email using mail

? as last resort.

? Thoroughly documents research done and action take on each claim in IMS

? Follows SOPs

? Proficient in Excel

? Proficient in Availity Essentials

? Communicates with other departments via shared spreadsheets and conducts regular followups

on cross communication.

Education, Prior Work Experience, Special Skill and Knowledge Requirements:

? High School Diploma

? Minimum 2 years of recent AR experience in a healthcare setting

? Proficient with Microsoft applications

? EMR experience – 2 years

? Proficient in denial management

? Experience working Commercial, Medicare and Medicaid plans.

? Experience working in fast-paced, high volume, multi-provider practice.

? Understanding of Revenue Cycle including admission, billing, payments, and denials.

? Hybrid schedule

Medical