Perform all follow up and denial activities.
Responsible for following up directly with commercial, governmental, and other payers to resolve claim payment issues.
Identify trends in denied payments by insurance companies to remediate issues.
Communicate with other departments to resolve denial issues and submit technical and clinical appeals in a timely manner.
Mentor AR Specialist team members to help develop and improve their skills in the follow up, denials and appeals process.
Follow up on clean claim delays from payors and adds issues to the escalation spreadsheets.
Assist leadership with special projects for AR reduction and Cash Acceleration.
Examine denied and other non-paid claims to determine reason for discrepancies.
Demonstrate initiative in resolving complex claims and proactively makes recommendations to management.

1 to 3 Years of experience in medical collections, physician/hospital operations, AR Follow-up, denials & appeals, compliance, provider relations or professional billing preferred.
Must demonstrate basic computer knowledge and demonstrate proficiency in Microsoft Excel.
Internal candidate must have met 120% Productivity and 98% Quality Assurance in each of the previous 3 months.
External candidates must meet quality and productivity standards by day 90.
Excellent Verbal skills.
Problem solving skills, the ability to look at account and determine a plan of action for collection.
Critical thinking skills, the ability to comprehend tools provided for securing payment, and apply them to differing accounts to result in payment.
Adaptability to changing procedures and growing environment.
Meet quality and productivity standards within timelines set forth in policies.
Meet required attendance policies.

Senior Accounts Receivable Specialist

Key skills