Accounts Receivable Associate

Role Summary

The Accounts 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 poral.
• Submit Medical Records upon request and follow up on submission.
• Submit HCFA’s claims to insurance companies that do not accept electronic claims.
• Submit Retros authorization
• Work closely with insurance companies to resolve claims disputes.
• Identifying and resolving billing errors and implementing processes to prevent future issues.
• Identifying and communicating process errors to optimize revenue cycle management.
• Utilize payor portals to gather claims status information.
• Respond promptly and professionally to inquiries from insurance companies, patient, and client’s representative 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

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

Education

• Preferred: Associate’s degree accounting, finance, healthcare administration, or a related field OR equivalent combination of education and experience

Skills

• Professionalism and strong organizational skills
• Effective communication (verbal and written)
• Customer service orientation
• Teamwork and collaboration

Additional Requirements

• Conditions of Employment: Successfully complete pre-employment process including criminal background check, drug screening, and reference verification.