Accounts Receivable Specialist is responsible for following up directly with commercial, governmental, and other payers to resolve claim payment issues
Identifies and analyzes denials, payment variances, and no response claims and acts to resolve claims/accounts
Provides support for all denial, no response, and audit activities
Examines denied and other non-paid claims to determine the reason for discrepancies
Communicates directly with payers to follow up on outstanding claims
Files technical and clinical appeals, resolves payment variances, and ensures timely and accurate reimbursement
Works with management to identify, trend, and address root causes of issues in the A/R
Maintains a thorough understanding of federal and state regulations, as well as payer specific requirements

2 or 4-year college degree preferred
1 or more years of relevant 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
Excellent Verbal skills
Problem solving skills
Critical thinking skills
Adaptability to changing procedures and growing environment
Meet quality and productivity standards within timelines
Meet required attendance policies

Accounts Receivable Specialist

Key skills