Ensemble Health Partners
Accounts Receivable Specialist:
- Responsible for following up directly with commercial and governmental payers to resolve claim issues and secure appropriate and timely reimbursement.
- Identifies and analyzes denials and payment variances and takes action to resolve account including drafting and submitting technical appeals.
- Examines denied and underpaid claims to determine reason for discrepancies.
- Communicates directly with payers to follow up on outstanding claims, file technical appeals, resolve payment variances, and ensure timely reimbursement.
- Ability to identify with specific reason underpayments, denials, and cause of payment delay.
- Works with management to identify, trend, and address root causes of issues in the A/R.
- Maintains a thorough understanding of federal and state regulations, as well as payer specific requirements and taken appropriate action accordingly.
- Documents activity accurately including contact names, addresses, phone numbers, and other pertinent information.
- Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management.
- Needs to be a strong problem solver and critical thinker to resolve accounts.
- Must meet productivity and quality standards.
- Performs other duties as assigned
Minimum Years and Type of Experience: High School Diploma
Other Knowledge, Skills and Abilities Required:
- Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel.
- Must pass typing test of 35 words per minute (error adjusted).
- Excellent Verbal skills.
- Problem solving skills, the ability to look at account and determine a plan of action for collection.
- Critical thinking skills, the ability to comprehend tools provided for securing payment, and apply them to differing accounts to result in payment.
- Adaptability to changing procedures and growing environment.
Other Knowledge, Skills and Abilities Preferred:
- 2 or 4 year degree.
- 1-3 years of relevant experience in medical collections or professional billing preferred.
- Knowledge of claims review and analysis.
- Working knowledge of revenue cycle.
- Experience working the DDE Medicare system.
- Working knowledge of medical terminology and/or insurance claim terminology.
- Certifications: CRCR within 6 months hire.
Scheduled Weekly Hours: 40
We’ll also reward your hard work with:
- Great health, dental and vision plans
- Prescription drug coverage
- Flexible spending accounts
- Life insurance w/AD&D
- Paid time off
- Tuition reimbursement
- And a lot more