Accounts Receivable Clerk

Insurance Claims Analyst

Demonstrates the ability to analyze, resolve, and prevent insurance rejections and claim denials.

Documents all responses and actions taken to reach claim resolution in the billing revenue cycle management system.

Reviews and resolves claim issues in assigned error processing and denial queues in billing accounts receivable management system.

Prepares billing, as required, including registration of patient demographic information, verification of insurance eligibility, review of charges, performs functions to validate accuracy, enters charges into the accounts receivable management system, and assembles supporting documentation as needed.

Ensures claims are submitted to the appropriate responsible party within designated filing limit guidelines.

Exhibits strong communication skills and a positive attitude with internal and external customers.

Maintains thorough knowledge of third-party eligibility and claim inquiry tools and applications, requirements, and regulatory guidelines.

Audits all explanations of benefits to confirm appropriateness of patient responsibility to ensure correct registration, coding, payment / adjustment posting, and insurance processing of claims.

Processes remittance, payment, and other documentation including scanning and submission of information according to CAHNs policy and procedure.

Meets or exceeds departmental productivity standards on a consistent basis.

Selects priorities and organizes work and time to meet them in order of importance.

Recognizes and researches problematic trends regarding non-payment in an effort to implement preventive measures to increase velocity of cash collections.

Informs the Revenue Cycle Manager of consistent issues as they occur and makes recommendations to improve departmental quality outcomes.

Communicates any payor changes and updates to Revenue Cycle Manager.

Participates as a team member by performing additional assignments not directly related to the job description when workload requires and as directed by management.

Maintains strictest confidentiality; adheres to all HIPAA guidelines and regulations.

Demonstrates attention to detail, initiative, and judgment.

Requirements Accounts Receivable (AR), Collections - Commercial, Cash Applications, Cash Collections, Billing Functions