| Company | Hunterdon HealthSee more |
 Address | Flemington, NJ |
 Form of work | Permanent |
| Category | Accounting/Finance |
Job description
Position Summary- The Accounts Receivable Specialist role and responsibilities include: following up directly with
commercial and governmental payers to resolve claim issues and secure appropriate and timely
reimbursement. Identify and analyze denials and payment variances and take action to resolve
accounts including drafting and submitting technical appeals. In addition, the AR specialist is the
subject matter expert for all billing staff regarding insurance payer billing procedures.
Primary Position Responsibilities- Responsible for reviewing and taking action on aged Accounts Receivables
- Responsibly includes: Following-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or payer portals
- Responsible for identifying and correcting medical billing errors
- Responsible for creating the evidence to dispute denied claims based on payer reimbursement rules when claims are erroneously denied through: investigating root cause of denial, compiling of data to support the overturning of a denial and creating the appeal documents, as well as following through on communication with third party payer to complete the recovery of denied funds.
- Responsible for providing support to billers and patient account representatives when explanation of patient responsibility is necessary.
- Responsible for identifying and analyzing trends for payer denials
- Perform special projects and other duties as needed. Assists with special projects by utilizing excel spreadsheets, and the ability to communicate results.
Qualifications- Minimum Education:
- Required:
- High School Diploma or Equivalent
- Preferred:
- Associate's Degree in Business Administration
- Minimum Years of Experience
- Required:
- Physician/Professional Billing Experience: 3+ years required experience in insurance payer
contracts, submitting appeals, and a complete understanding of insurance payer's explanation of
benefits and payer reimbursement rules.
- Preferred:
- License, Registry or Certification:
- Knowledge, Skills and/or Abilities:
- Required:
- Must have strong organizational, problem solving and critical thinking skills
- Experience working with insurance payer portals such as Navinet and Availity.
- Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes
- Ability to analyze, identify and resolve issues causing payer payment delays
- Ability to work well individually and in a team environment
- Experience with practice management system, NexGen preferred; intermediate skills with Microsoft Office
- Strong communication skills/oral and written
- Preferred:
Refer code: 8152903. Hunterdon Health - The previous day - 2024-02-07 17:12
