Certified Accounts Receivable Specialist
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Description
Experience Level: Intermediate
Job Description
The Corporate Billing Office Certified Accounts Receivable Specialist coordinates all billing and collection activity as related to the insurance payer accounts receivable. Acts as a resource to all departments of the health system as their needs relate to contracted insurance payers and coding. Performs other patient account duties as assigned.
Responsibilities
PART III: POSITION RESPONSIBILITIES (ESSENTIAL FUNCTIONS)
Analyze the payer remittance notice and perform necessary follow-up of denied claims and those claims that require additional billing (i.e. supplement insurance, appeals, etc.)
Identify any coding/billing related changes to colleagues and management on a regular basis.
Maintain assigned payer financial class receivables within designated benchmarks.
Maintain Coding Certification.
Maintain patient demographic information, report information that may be related to compliance (i.e., discharge, status code errors; medical necessity failures).
Responsible for covering the overflow incoming Customer Service calls, billing or payment posting when needed.
Review claims to insure received by payers; check claim status, can resubmit claims if not received by payer via electronic submission or paper.
Reviewand analyze all coding related denials and report trends to management/sites for feedback to providers.
Understand and apply Medicare LCD and NCD requirements - reviewing those cases that fail medical necessity and performing proper and timely follow-up to ensure compliance with the regulations.
Understand Medicare billing requirements, and other Assigned Payers, defined by contract, state, or federal law.
Qualifications
Experience/Education Requirements:
High school graduate or equivalent
At least 2 yrs experience in a position of accounts receivable follow-up preferred
Has consistently maintained assigned accounts receivable within designated benchmarks
Thorough knowledge of CMS coding and documentation guidelines
Experience working with multi-specialty billing, documentation and follow up
Strong interpersonal skills including verbal and written
PC and keyboarding skills
Experience in the use of Microsoft Office Products preferred
Strong mathematical skills
License or Certification Requirements:
The Corporate Billing Office Certified Accounts Receivable Specialist coordinates all billing and collection activity as related to the insurance payer accounts receivable. Acts as a resource to all departments of the health system as their needs relate to contracted insurance payers and coding. Performs other patient account duties as assigned.
Responsibilities
PART III: POSITION RESPONSIBILITIES (ESSENTIAL FUNCTIONS)
Analyze the payer remittance notice and perform necessary follow-up of denied claims and those claims that require additional billing (i.e. supplement insurance, appeals, etc.)
Identify any coding/billing related changes to colleagues and management on a regular basis.
Maintain assigned payer financial class receivables within designated benchmarks.
Maintain Coding Certification.
Maintain patient demographic information, report information that may be related to compliance (i.e., discharge, status code errors; medical necessity failures).
Responsible for covering the overflow incoming Customer Service calls, billing or payment posting when needed.
Review claims to insure received by payers; check claim status, can resubmit claims if not received by payer via electronic submission or paper.
Reviewand analyze all coding related denials and report trends to management/sites for feedback to providers.
Understand and apply Medicare LCD and NCD requirements - reviewing those cases that fail medical necessity and performing proper and timely follow-up to ensure compliance with the regulations.
Understand Medicare billing requirements, and other Assigned Payers, defined by contract, state, or federal law.
Qualifications
Experience/Education Requirements:
High school graduate or equivalent
At least 2 yrs experience in a position of accounts receivable follow-up preferred
Has consistently maintained assigned accounts receivable within designated benchmarks
Thorough knowledge of CMS coding and documentation guidelines
Experience working with multi-specialty billing, documentation and follow up
Strong interpersonal skills including verbal and written
PC and keyboarding skills
Experience in the use of Microsoft Office Products preferred
Strong mathematical skills
License or Certification Requirements:
Keneth S.
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Last project
11 May 2024
United States
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