As a member of the Revenue Cycle Team, the Billing and Accounts Receivable Specialist is responsible for the accurate and timely billing of services, to Medicare, Managed Care, Medicaid and Commercial Medical Claims. Posting of payments, verification of authorizations, claim resolution and accounts receivable follow-up of outstanding balances.
Accounts Receivable Responsibilities:
• Identify and resolve unpaid claims and report issues to the supervisor.
• Weekly monitoring and monthly reporting on the status of accounts receivable over 30 days in arrears provide details of collection efforts and issues with securing reimbursement.
• Perform collection actions including contacting funders, clients, and guarantors by phone, email, and mail.
• Perform insurance eligibility; correctly utilize ICD diagnosis codes, CPT/HCPC codes, and modifiers to ensure accurate and timely payments.
• Utilize knowledge of the pre-certification and authorization process to ensure all certifications and authorizations are valid and accurate.
• Ensure compliance with billing practices, policies, and procedures by leveraging strong knowledge of the policies and rules stipulated by Medical Assistance, Managed Care, Third Party, Auto Liability, Private Pay and various school districts.
• Timely submission of claim corrections and resubmission of invoices and claims when necessary.
• Provide exemplary customer service to patients, office staff, and providers.
• Work collaboratively with other departments and programs to gather and provide information on authorization and eligibility issues.
• Maintains quality results by following established policies and procedures.
• Share knowledge of current regulations, policies, and developments with team members and office administrators. Maintain strict confidentiality with regard to all client information.
Adheres to all HIPAA and OIG guidelines/regulations.
• Demonstrate a strong commitment to performance accountability.
• Respond to inquiries from management staff regarding billing and account related matters.
• Attend relevant seminars and training sessions to improve knowledge, skills and performance as specified by the Billing Supervisor or the Revenue Cycle Manager.
• Other duties as assigned by the Billing Supervisor or the Revenue Cycle Manager.