Accounts Receivable Specialist

Job Title:Accounts Receivable Specialist – Full Time

Industry: Physician Billing

Location: In Office

Required minimum years of experience: 2 – 4

Pay: Hourly $18.77 – $22.77

Competitive Benefits: Medical, Dental, Vision, STD, LTD, HSA (as applicable with Employer contribution), 401k Plan with employer match.

Welcome to Pinnacle! Pinnacle Healthcare Revenue Solutions (PHRS) is a full Revenue Cycle Management (RCM) company focused on professional billing for independent physician practices. PHRS is a division of Pinnacle Healthcare, a growing healthcare consulting company based in Colorado with regional offices in St. Louis, Missouri, Indianapolis, Indiana, Phoenix, Arizona and remote employees in 23 states. We offer our employees a GREAT team environment, wonderful camaraderie among the team members, and a true appreciation and recognition for hard work.

Description

PHRS is comprised of specialists in the areas of coding and charge entry, cash posting, and Accounts Receivable management for various medical subspecialties utilizing a variety of electronic health record and practice management software platforms to support our clients. Our RCM services incorporate numerous operational efficiencies to capture patient demographics, health status, visit notes, and billing information to provide these critical daily functions in support of each practice. In addition, our management team provides a strategic partnership with our client practices to ensure compliance with all regulatory standards, produce summary reports of all activity; document production and revenue trends; and recommend changes in policy and procedure to create efficient and effective business operations.

Role

The main purpose of this position is to support the PHRS mission, vision, core values and customer service philosophy.

This candidate will continuously interact with physicians, patients and insurance vendors to investigate outstanding claims and incomplete payments. This position will also be responsible for providing first level customer support for billing services which includes answering phones and researching patient account issues. The ideal candidate will be able to maintain proficiency and appropriate level of knowledge with all systems that is required for task completion. Additionally, this position is responsible for completing patient billing and investigating daily denials by working with insurance vendors and adjusters to resolve problem accounts and re-file open claims.

• Accountable for outstanding customer service to all external and internal
• Develops and maintains effective relationships through effective and timely communication.
• Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner.

Education

- High School diploma or equivalent is required.

- Associates Degree or higher in Medical Billing and Coding or a related field is preferred. A degree is not required if candidate has at least 2 years of prior billing experience in a physician practice medical billing environment.

Other Knowledge, Skills, Abilities and Behaviors

• Minimum 2 years of experience in medical billing or has graduated from an accredited medical college.
• Candidate must understand government and managed care payment methodologies and demonstrate knowledge of terms such as contractual adjustment, allowed amount, coinsurance, denial and denial processes.
• Experience in billing or health insurance claim processing preferred. CPT, ICD-9, and HCPCS coding knowledge preferred.
• Required to stay until 6:00 PM EST approximately one time every six weeks, in rotation, with other AR Specialists in order to cover customer service lines.
• Knowledge of business office procedures
• Ability to establish and maintain an effective working relationships with patients, physicians, client practice staff, and co-workers.
• Ability to operate a computer, copier or fax machine
• Ability to sort and file materials correctly by alphabetic or numeric systems.
• Verbal and written communication skills.
• Knowledge of Microsoft Office Products.
• Experience in one or more of the following billing software platforms is preferred - EPIC; Ideal; Allscripts; Centricity; Acumen-Epic; iSalus; Athena
• Experience in one or more of the following specialties is preferred – Nephrology; OB/GYN; Gastroenterology; Internal Medicine; Long Term Care.

Specific Duties

• Maintain up-to-date patient demographics and insurance information
• Identify errors through coding, charge entry and cash application processes.
• Complete daily denials by working with insurance companies and adjusters to resolve problem accounts, re-file and re-open claims, file appeals and make decisions on adjustments.
• Investigate and work claims based on aging from date of service
• Refer refund request to refund specialist
• Provide first level customer service support for billing services including answering patient’s questions and researching account issues. Assist with customer’s pending items including charges, payments and denials and follow-up to confirm these items are resolved.
• Document activity in an accurate and timely manner on the patient’s account.
• Review and prepare accounts for collections.
• Complete and communicate progress on assigned tasks to Manager.
• Maintain proficiency and an appropriate level of knowledge with all systems required for task completion.
• Ensure compliance with all state and federal billing regulations, including HIPAA, and report any suspected compliance issues to the respective Manager or RCM leadership.
• Work with RCM management team to improve processes, increase accuracy, create efficiencies and achieve the overall goals of PHRS.
• Other duties as assigned.

Work Environment/Other Information

• In office position, with flexibility as to arrival/departure times
• Remote work option available
• Proficiency in communication using Teams, Zoom, or Webex