Accounts Receivable Specialist -Medical Billing

Core Clinical Partners stands at the forefront of Emergency and Hospital Medicine, delivering unparalleled services through a model that emphasizes patient-centric care and operational excellence. Our corporate values - Genuine, Accountable, Dynamic, Respectful, and Fun - are the pillars that uphold our commitment to revolutionize healthcare delivery.

The Accounts Receivable Specialist will utilize multiple EMR systems to review and satisfy billing edits, charge information, private or government insurance benefits, and other related information from multiple billing and documentation servers (for multiple hospitals, clinics and insurance companies). Under the direction of the AR Manager, the AR Specialist will follow up on outstanding AR all payers including self-pay and resolution of denials. This position is responsible for handling all correspondence related to an insurance or patient account, contacting insurance carriers, patients and other facilities as needed to get maximum payment on accounts and identify issues or changes to achieve client profitability.

Essential Duties :

• Investigate, follow up with payers, and collect the insurance accounts receivables assigned by the manager of outsourced and internal AR aging, clearinghouse rejections, and payer denials.
• Perform comprehensive follow up activities that facilitate cash collections and document follow up activity in the appropriate system.
• Maintain professional interaction with colleagues and clients
• Identify any payer-specific issues and communicates to team and manager
• Comply with performance and productivity standards while maintaining quality levels, as set forth by senior leadership
• Navigating and utilizing payer websites for appeals / reconsiderations, medical records attachments, verification of benefits and / or web-based claims follow up
• Researches and completes special projects and requests as needed.
• Participates in staff meetings and assigned continuing education, and recommends new approaches, policies, and procedures to effect continual improvement in efficiency of the department and services performed.
• Maintains a strict level of confidentiality for all company, departmental, and healthcare provider information.
• Performs other related duties as assigned.

Skills, Knowledge, Abilities :

This is a hybrid role based out of our Lafayette, LA office.

Core Clinical Partners is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Requirements

Education :

Experience :

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