Medical AR Specialist
Winston Salem, NC 27104
Responsible for assisting in the development and implementation of the company’s Central Billing Operation.
Ensure that all insurance verification, prior authorizations, billing, and efficient cash collection through excellent reimbursement practices are conducted in a manner consistent and in support of all company policies and procedures. Conducts all activities in a professional manner while working closely with the branch offices and the Corporate office.
Role and Responsibilities
• Possesses and consistently demonstrates a thorough knowledge of all rules, regulations and practices of all pay sources, including but not limited to Medicare, Medicaid, third party pay sources, and any related contracts.
• Possesses and consistently demonstrates a thorough knowledge of all billing systems, electronic and other, as applicable.
• Demonstrates and practices understanding of reimbursement rates and communicates such appropriate information to patients.
• Recognizes the necessity of working closely with all branch offices to insure consistency in submission of applicable data required to maintain accuracy and timeliness in billing.
• Ensures daily follow up on all open accounts, maintaining accurate collection records, and efficient cash collection for each patient account.
• Coordinate communications with payers to ensure accurate billing billing practices, achieve cash collection targets and reduction of A/R is maintained at company expectations.
• Manages the status of accounts, balances and identifies inconsistencies in payment.
• Performs follow-up on insurance claim status, resolve denials, submit corrected claims and files appeals.
• Provide counseling to patients advising them of their financial responsibilities and obtain credit agreements for outstanding balances.
• Requests appropriate adjustments and refunds when required.
• Performs other duties or special projects as assigned.
• Strong customer service, interpersonal, oral and written communication skills
• Strong knowledge of insurance claims processes and following up on aging account receivables.
• Understanding of medical reimbursement terminology and complete understanding of general office duties.
• Proficient computer skills including Windows based office technologies, email, automated billing systems and payer portals.
• Ability to use all necessary office equipment, scanner, facsimile machines, calculators, postage machines, copiers, etc.
• Knowledge of state, federal, regional collection and reimbursement laws where applicable.
• Excellent organizational skills and the ability to manage tasks.
• Proficiency with basic math and accounting skills. Ability to key 50 words per minute with accuracy.
• Ability to work effectively as a team member.
• Ability to walk, bend, and reach constantly during a work day/shift.
• Visual acuity (near and distant) sufficient to maintain accurate records, recognize people, and understand written direction.
• Ability to speak and hear sufficient to understand and give directions.
• Ability to participate in sustained activities for many hours in duration with state labor laws.
Qualifications and Education Requirements
• High school diploma or equivalent combination of education and experience required. Associate degree preferred in Business Administration, Accounting or Health Care Administration preferred.
• Minimum two to three years medical office administrative experience with a concentration in accounts receivable required.