District Medical Group
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Accounts Receivable Specialist II
at District Medical Group
Essential Duties and Responsibilities:
The Accounts Receivable Representative II is responsible for tenacious follow-up of accounts receivables. Utilizing work files, reports, online and telephone communications. Responsible for writing appeals and adjustment requests. Works independently and have a strong understanding of the job duties and responsibilities.
- Communicate effectively with insurance carriers, staff members and management.
- Daily average - process collections of 50 invoices per day
- Must have the ability to appropriately document the system so that all staff can understand and it can be used as legal documentation if necessary.
- Identify when errors are occurring in registration, billing and follow-up.
- Identify denial trends.
- Efficiently and effectively navigate IDX, EPIC, ETM and online payer websites.
- Maintain client and patient confidentiality.
- Denial management - work insurance denials and take necessary action to send corrected claim to payer.
- Telephone calls - must know the appropriate information required by payers as well as appropriate questions to ask.
- Write appeal letters and attach appropriate documentation to get the claim paid.
- Review/work invoices on denial and aging reports.
- Perform related duties as assigned by supervisor.
- Maintain compliance with all company policies and procedures.
- 2 + years medical collections experience preferred
- Prior experience with IDX/EPIC preferred.
- High school diploma or equivalent
- Billing and Coding certification preferred
- Highly skilled in knowledge of medical collections practices and job expectations.
- Knowledge working with commercial insurance, self-pay, Medicare, Medicaid, AHCCCS
- Health insurance knowledge with regards to billing requirements, timely filing requirements and appeals process.
- Knowledge of payer specifics.
- Knowledge of business office procedures.
- Understanding/compliance of HIPAA laws and regulations.
- Able to differentiate between primary and secondary insurance payers.
- Computer proficiency (MS Office – Word, Excel and Outlook)
- Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers.
- Ability to read, understand and follow oral and written instructions.
- Must be well organized and detail-oriented.
- Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
- Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices.
- Able to work in a team environment.
- Ability to operate standard office machines and equipment, including telephones, computers, copy machines, fax machines, calculators, scanners and shredders.
- Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
- Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards
- Ability to type __35__wpm
- Must be able to talk, listen and speak clearly on telephone
- Requires sitting and standing associated with a normal office environment.
- Manual dexterity needed for using a calculator and computer keyboard.
- Specific vision abilities include close vision, distance vision, depth perception and the ability to adjust focus.
Environmental Working Conditions:
- Normal office environment.
- The noise level of the work environment is usually moderate.
- Occasional overtime maybe required and/or hours may be shortened as business needs dictate.
*The job holder must demonstrate current competencies applicable to the position.