Medical A/R Specialist

Hannah Medical Consulting, LLC

JOB DESCRIPTION

Position: Accounts Receivable Specialist

Reports to: Vice President, Billing Services

Salary: Salaried, $30,000 (roughly $24/hour)

Hours: Part-time, 3 days per week

An Accounts Receivable Specialist plays a crucial role in the healthcare industry by ensuring accurate and timely processing of medical claims and maintaining the integrity of patient records. This role involves translating medical procedures and diagnoses into universally recognized codes, verifying insurance information, and submitting claims to insurance companies or government programs for reimbursement. The specialist must possess a strong understanding of medical terminology, coding guidelines, and healthcare regulations.

Basic Responsibilities

• Telephone insurance carrier/patient to seek resolution on account
• Research why claims are not being paid and make any necessary changes
• Resolve inappropriate payments with insurance carriers that are not in compliance with payer contracts or governmental agency rates on individual accounts
• Utilize specialized knowledge of contracts, regulatory or contractual billings guidelines to determine an account’s ability to pay after initial rejection from payer
• Coordinate duplicate billings, coordination of benefits, medical records or clinical documents as needed to expedite payment of insurance claims
• Identify trends in payer non-compliance and inform management if not able to resolve with payer
• Negotiate within specified guidelines with payers
• Ensure secondary carrier is appropriately billed or self-pay portion is pursued
• Follows up with appropriate staff to locate missing information
• Ensure accurate and timely billing of all outstanding account balances to the appropriate third party payers and patient guarantors
• Maintain necessary logs
• Answer telephone calls as needed
• Assist with the planning and organization of departmental activities as needed and participate in said activities
• Participate in departmental meetings as necessary
• Any other jobs as assigned by the VP of Billing Services.

Preferred Skills

• Must have experience working with multiple different specialties
• Must have experience with several different practice management systems (EHR)

Required Qualifications

• High school diploma or equivalent; completion of a medical billing and coding program or certification from a recognized organization (e.g., AAPC or AHIMA).
• Proficiency in ICD-10-CM, CPT, and HCPCS Level II coding systems.
• Familiarity with healthcare billing software and electronic health records (EHR) systems.
• Attention to detail and accuracy in coding and data entry.
• Excellent organizational and time management skills.
• Knowledge of healthcare regulations, including HIPAA.
• Strong communication skills for effective collaboration with healthcare providers and insurance representatives, both written and verbal.
• Ability to adapt to changes in coding guidelines and industry regulations.
• Ethical conduct and respect for patient confidentiality.

An Accounts Receivable Specialist plays a pivotal role in healthcare administration, ensuring that medical claims are processed efficiently, healthcare providers receive proper reimbursement, and patient records are maintained with precision and compliance.

Job Type: Part-time

Benefits:

• Flexible schedule
• Work from home

Experience level:

• 1 year

Schedule:

• 8 hour shift

Work Location: Remote