Manor, TX 78653
Salary: $15.00 to $18.00 /hour
Billing and Accounts Receivable (AR) Follow-Up Specialist
Full Charge Bookkeeper
Position Summary The Billing and Accounts Receivable (AR) Follow-Up Specialist is a full-time position with benefits. account. Insurance Billing and AR recovery would be your primary responsibility; however, you will have a varying secondary workload determined by need and strategic planning to advance your skill set. The Billing and Follow Up Specialist role is utilized to expose team members to the systems we use, the vast carrier specificities and the correct methodology for each denial and how the revenue cycle as a whole effects and is effected by the AR. This will cultivate your knowledge and understanding organically preparing you for growth and advancement. Simultaneous, we will provide you with secondary tasks in other functional areas of the revenue cycle, maximizing your exposure and fostering an advantageous environment geared towards your professional growth.
Duties and responsibilities
· Reconcile and submit charge and service provider claims to insurance
· Partner with Billing and Accounting departments to ensure timely submission and processing of claims, posting of charges, payments and adjustments, and timely payment of services provided.
· Partner with internal service delivery departments to ensure Utilization Review and Management process is supported, authorization for insurance is obtained, and insurance reimbursement is secured.
· Analyze insurance reimbursement charge, adjustment, and payment receipts.
· Perform follow-up actions with insurance companies to ensure timely and full payment.
· Ability to recognize correct denials and make the appropriate adjustment in PM system as needed.
· Ability to recognize correct recoupments and make the appropriate adjustment in PM system as needed.
· Ability to recognize incorrect recoupments and appeal the decision per correct carrier guidelines.
· Utilize account information to assist in write-offs for inclusive CPTs by payor.
· Update job knowledge by participating in educational opportunities.
· Serve and protect sensitive information by adhering to professional standards, company policies and procedures, federal, state, and local requirements, and standards.
· Learn, maintain, and apply multiple recovery methodologies respective to carrier specific medical policies, denials, and appeal processes.
·Trend, classify, resolve, and communicate issues in the AR to optimize your individual productivity but to also resolve front end issues that improve the health of the account(s) you are assigned.
·Manage both quality and quantity on a consistent basis, continually seeking to out perform yourself and grow your professional knowledge in the process.
· Ability to identify and appropriately escalate issues on any patient account being reviewed and resolve the concerns properly and efficiently
· Ability to multitask, moving from primary to secondary tasks while maintaining target and deadline driven goals.
· Ability to utilize multiple resources in identifying denials and the appropriate approach in seeking resolution and reimbursement including but not limited to: Medical policy bulletins, LCD’s, NLCD’s, CCI edits, Carrier Sites, Remittance/Remark codes, EOBs, Correspondence, AASO GSD, account alerts.
Skills & Specifications:
· At least 2 years of medical billing experience.
· At least 2 years of previous experience in an AR Recovery driven role.
· Knowledge of Practice Management and Electronic Medical Record systems
·Strong communication, initiative driven work ethic and teamwork environment skills.
·Exceptionally detailed, organized, and highly accurate with ability to successfully manage multiple projects simultaneously.
· Understanding of Anatomy and medical terminology.
· Understanding of CPT codes, HCPCs codes, ICD-10 codes.
· Understanding of ERA EOB remittances and insurance carrier coordination of benefits and processing – preferred.
·Working knowledge of programs such as, Outlook, Excel, and Word etc.
·Well-developed interpersonal communication skills to work effectively with people from diverse professional and cultural backgrounds.
·Working Knowledge of: Medical policy bulletins, LCD’s, NLCD’s, CCI edits, Carrier Sites, Remittance/Remark codes, EOBs, Correspondence, AASO GSD, account alerts.
·Must have excellent telephone skills, excellent verbal communication, listening, Professionalism, must be punctual, possess excellent customer service skills, and organization.
·Must have knowledge of behavioral health insurance
· High School Degree or equivalent (Required)
· Bachelor’s degree in Healthcare or Business-related field (Preferred)
· Degree or certification in medical billing (Preferred)
· Coding Certifications, CPC, COSC (Preferred)
· Pay: $15-$18 hour
· 8-hour shifts
· Monday through Friday
· Primary location in Westlake and Manor depending on facility needs
· Medical, Dental, Vision & Short-Term Disability Insurance
· Paid Holidays depending on office coverage
· Paid time off