Ensemble Health Partners
Job Description:
The Accounts Receivable Specialist role responsibilities include following up directly with commercial and governmental payers to resolve claim issues and secure appropriate and timely reimbursement. Identify and analyze denials and payment variances and take action to resolve account including drafting and submitting technical appeals.
Other Job Duties include:
- Examine denied and underpaid claims to determine the reason for discrepancies.
- Communicate 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 the root causes of issues in the A/R.
- Maintain a thorough understanding of federal and state regulations, as well as payer-specific requirements and take appropriate action accordingly.
- Document activity accurately including contact names, addresses, phone numbers, and other pertinent information.
- Demonstrate 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 Qualifications: 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 the 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.
- 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 with the DDE Medicare system. Working knowledge of medical terminology and/or insurance claim terminology.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Scheduled Weekly Hours: 40
Work Shift: Days (United States of America)
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