Accounts Receivable Specialist

Responsibilities The Accounts Receivable Specialist is responsible for the accurate and timely follow-up of unpaid claims, by assigned payer / s and defined aging criteria to meet or exceed collection targets and minimize write-offs.

Researches claim denials by assigned payer / s to determine reasons for denials correcting and reprocessing claims for payment in a timely manner.

Meets or exceeds established performance targets (productivity and quality) established by the A / R Supervisor. Initiates and follows-up on appeals recognizing the payer defined aging criteria.

Exercises good judgement in escalating identified denial trends or root cause of denials to mitigate future denials, expedite the reprocessing of claims and maximize opportunities to enhance front end claim edits to facilitate first pass resolution.

Identifies uncollectible accounts and performs accurate and timely write-offs (e.g. no authorization) adhering to IPM CBO policy guidelines.

Demonstrates the ability to be an effective team player. Upholds best practices in day to day processes and work flow standardization to drive maximum efficiencies across the team.

Qualifications Education : High School Graduate / GED required. Technical School / 2 Years College / Associates Degree preferred.

Work experience : Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance or equivalent operations work environment.

Knowledge : Healthcare (professional) billing, knowledge of CPT / ICD-10 coding, government, managed care and commercial insurances, claim submission requirements, reimbursement guidelines, and denial reason codes.

Understanding of the revenue cycle and how the various components work together preferred.