Accounts Receivable Specialist

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