Accounts Receivable (AR) Associate

Role Summary

Accounts Receivable (AR) Associate — The Account Receivable Associate is responsible for reviewing outstanding denied claims with Medicare, Medicaid and Commercial insurance companies. This role involves following up with insurance companies to check claim status, reviewing medical records request and submitting required documentation to payors.

Responsibilities

• Review insurance denials and take appropriate action.
• Check claims status via phone or portal.
• Submit Medical Records upon request and follow up on submission.
• Submit HCFA‚Äôs claims to insurance companies that do not accept electronic claims.
• Submit Retros authorization.
• Work closely with insurance companies to resolve claims disputes.
• Identify and resolve billing errors and implement processes to prevent future issues.
• Identify and communicate process errors to optimize revenue cycle management.
• Utilize payor portals to gather claims status information.
• Respond promptly and professionally to inquiries from insurance companies, patients, and client‚Äôs representatives with good customer service.
• Ensure billing practices comply with HIPAA, CMS guidelines and payor specific policies.
• Communicate with insurance companies daily.
• Must meet or exceed production and quality standards.

Qualifications

• Required: High School diploma or equivalent.
• Required: 1-2 years of experience in a related industry.
• Required: Strong understanding of Explanation of Benefits (EOBs) to determine denial reasons and appropriate actions.
• Required: Strong communication and interpersonal skills.
• Required: Ability to work independently and as part of a team.
• Required: Attention to detail and strong organizational skills.
• Required: Basic experience using computer software, including medical billing software.
• Required: Proficient in Microsoft Office Suite (Word, Excel, Outlook) and general internet for business use.
• Required: Strong problem-solving skills with attention to detail.
• Required: Moderate knowledge of CPT, ICD-10.
• Required: Ability to adapt to frequent changes and manage tasks efficiently.

Preferred Qualifications

• Associate‚Äôs degree in accounting, finance, healthcare administration, or related field, or equivalent experience.
• Professionalism, strong organizational and communication skills, and persistence in follow-up.
• Drive for results and continuous improvement of procedures/processes.
• Strong verbal and written communication skills; ability to share and receive information across the organization.
• Teamwork and customer service focus.

Physical Demands

• Sitting and/or standing for long periods.
• Repetitive motion.
• Ability to lift up to 15 pounds.
• Desk/cubicle environment.

Education

• High School diploma or equivalent (required)

Additional Requirements

• Willingness to work shift work and overtime; occasional weekends, evenings, and/or holidays.