Accounts Receivable Specialist - Remote

📋 Description

• • Submits patient billing claims to appropriate insurance payers and third-party entities with accuracy, ensuring compliance with contracts, regulations, and departmental standards.
• • Conducts comparative analysis of billing data including charges, subscriber information, diagnosis/procedure codes, and late charges to verify accuracy prior to submission.
• • Processes claims in a timely manner to meet deadlines and maximize reimbursement efficiency while adhering to payer-specific requirements.
• • Initiates and follows up on phone calls to insurance companies, patients, guarantors, family members, and clinical staff to determine the status of unpaid, rejected, or unprocessed claims.
• • Resolves claims issues by reviewing and processing correspondence from payers and patients, taking appropriate actions to expedite payment resolution.
• • Verifies insurance eligibility and patient demographic information at time of registration or as needed, and inputs updated data into internal systems to support accurate claims generation.
• • Re-bills accounts when new or corrected information becomes available, updating patient records to reflect changes in demographic or third-party payer details.
• • Monitors internal and external reports to track claims status, identify delays, and ensure timely follow-up on outstanding receivables.
• • Maintains detailed documentation of all communication and actions taken regarding accounts receivable to support audit readiness and compliance.
• • Collaborates with department teams and other healthcare providers to resolve billing discrepancies and ensure accurate financial records.
• • Ensures all billing activities align with organizational policies and regulatory guidelines to minimize denials and maximize revenue cycle efficiency.
• • Communicates clearly and professionally with patients and families regarding outstanding balances and payment obligations.
• • Maintains strict confidentiality of all patient and financial information in accordance with HIPAA and organizational privacy standards.
• • Supports continuous improvement by identifying trends in claim denials and recommending process enhancements to reduce future errors.
• • Works within a climate-controlled office environment with scheduled daily movement throughout the facility.
• • Performs duties in a structured 40-hour weekly schedule during daytime hours, Monday through Friday, with no overtime exemption.
• • Maintains accurate, up-to-date records and ensures data integrity in all billing and accounts receivable systems.