Position Summary
The Account Receivable Associate reviews outstanding denied claims with Medicare, Medicaid and Commercial insurance companies. Follow up with payors to check claim status, submit requested medical records documentation, and assist with claim resolution.
Job Responsibilities
- Review insurance denials and take appropriate action.
- Check claims status via phone or portal.
- Submit medical records upon request and follow up.
- Submit HCFAβs claims for payors that do not accept electronic claims.
- Submit retro authorization.
- Resolve claims disputes with insurance companies.
- Identify and resolve billing errors; implement process improvements.
- Identify and communicate process errors to optimize revenue cycle management.
- Use payor portals to gather claim status.
- Respond promptly and professionally to inquiries from insurance companies, patients, and client representatives.
- Ensure billing practices comply with HIPAA, CMS guidelines, and payor-specific policies.
- Communicate with insurance companies daily.
- Meet or exceed production and quality standards.
Required Qualifications
- High School diploma or equivalent.
- 1β2 years of related experience.
- Strong understanding of Explanation of Benefits (EOBs).
- Strong communication and interpersonal skills.
- Ability to work independently and in a team.
- Attention to detail and strong organizational skills.
- Basic computer experience, including medical billing software.
- Proficient in Microsoft Office (Word, Excel, Outlook) and general internet use.
- Problem-solving skills.
- Moderate knowledge of CPT and ICD-10.
- Ability to adapt to frequent changes.
Preferred Qualifications
- Associateβs degree in accounting, finance, healthcare administration, or related field (or equivalent experience).
- Professionalism; strong organization and communication skills; persistent follow-up; drive for problem resolution.
- Drive for results (service, quality, continuous improvement).
- Proficient verbal and written communication.
- Teamwork and customer service focus.
Application/Other
- Willingness to work shift work and overtime; occasional weekends/evenings/holidays.